Forum - Questions & Answers

Dec 17th, 2009 - STH

Consults (non-Medicare) requirements

I'm going to ask a basic coding question, that I want to get some confirmation on...

For the non-Medicare world...can multiple consults be conducted by a physician, for the same patient, over separate hospital admissions? E.g. The admitting physician calls in a specialist, when the patient is admitted to the hospital...the patient has had several admits and discharges over the course of a year, and the specialist is called in to see the patient each time. Can the specialist charge a hospital consult each time he is called in by another physician?

Does anything change if this same patient is an established office patient?

Thanks.

Dec 17th, 2009 -

You bet!!!!

Every time the doc is asked to see the patient, it is a consult in the hospital (only limit is once per admission) even if they are also seen in the office as an established patient.

Dec 22nd, 2009 - Codapedia Editor 1,399 

multiple consults on a patient admitted multiple times

Yes, the inpatient consultations are not divided as new or established, and so can be billed on a patient in different admissions.

I always remind physicians: keep in mind the medical necessity of the level of consult. If this is your established patient, and you are asked to consult during an admission: what level of history and exam do you need? They don't all have to be high level.



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