Can I bill a consult

The provider saw a patient for warts on both hands and lower left leg. She talked about these, and bumps that had appeared on the patient's face. She ended up in a face to face and "counseled greater than 30 min"
She applied liquid nitroge to destroy. The only notes I have are this and that the pt had "multiple flat warts on right hand and left leg"
Dx codes on claim were
1. Warts, Viral- 078.10 (primary)
2. Seasonal allergic rhinitis- 477.9
She billed
17000 and 17003 (indicating up to 14 benign lesions.)

I don't think this is correct coding and I have several notes I plan to take to her, but she is very specific, and if she asks me a question I don't immediatly know she might think I don't know what I'm saying...

That in mind,
1- I should defininatly have the Dr. document better and in more detail, I have plenty on what is needed for that...
2- I plan to suggest for "Flat warts" to bill 17110 (under 15), not 17000 and 17003, right?
3- Shouldn't there be room for a consult in this visit? I know the documentation is lacking, but I plan to use this as an example for future documentation errors, with her note of 30+ mins, plus the allergies dx, (and I know the Dr. always tries to address everything with the pt even if not related to the visit,) would I be able to charge a OV or consult? If so, what would code be suggested, as I am uncertain in this area?

Thanks!

can I bill a consult

Not from the documentation you describe, only wart destruction, with the code you selected (not 17000 and 17003).

Search for the article, "Can we bill a low level E/M service with every procedure"

Definitely not a consult

I see nothing to indicate that pt was referred by another doc or that notes sent to referring doc.
With better documentation "Referred by Dr X for allergies and warts" and a discussion of history, physical and advice for allergies, I could see a consult for allergies with -25 linked to 477.9 and the wart diagnosis and destruction code to cover the wart destruction with no associated office visit.
But oh boy does the doc need to document better!

Can I Bill A Consult?

Who is asking for the Consultation?

Not sure

I'm not sure if I can bill a consult. When I worked for an ins. co, we reviewed for need of a consult, not another Dr involved. I recall several times where the consult was allowed or not allowed (based on type of surgery) for "decision making". I have never been able to find an exact answer on this, since the code description states: "requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making." I have always wondered if this requires another dr be involved or not.

Seperately can the Dr bill a consult when she spends an 30+ mins on the phone with another dr, but does not see the patient until a later day? I really don't know when/how and our dr is asking me and I don't know what to tell her.

consults

Search in the Codapedia Encyclopedia by putting "consultations" and "consults" into the search box above, "Look it up." There are a ton of articles that describe both the CMS and CPT definition. Consults require a request from another healthcare professional.

Consulting with an MD over the phone does not allow you to bill a consult or any E/M service.

30 minutes on the phone...really???

I have never seen a doctor on the phone for 30 minutes with another doctor!

Perhaps Editor can comment - if the phone call was really 30 minutes AND on the same day as the visit, does it count? So for example, Dr X calls me to discuss Mrs. P who I will see in the afternoon. We go over her hx and previous tests and what the other doc plans and then I see her, review this info and do my own decision making. 30 min with doc, 20 min with patient- does it all count?