Forum - Questions & Answers
asked for re-consult.
I saw a patient in the hospital for small bowel obstruction (hospital consult). Patient did fine without any surgery (therefore no global) and went home. He was re-admitted by the primary 1 month later for the same symptoms and again I was asked to consult. I know this has been asked before (and my apologies for asking again), but how would the second consult be coded...is this a hospital consult again (keep in mind its for a recurrence of the same problem) or is this an established hospital visit? (Assume that all of the documentation requirements for consultation are met). Thanks.
consult
Medicare allows one consult/hospitalization.
She really means
One consult per hospitalization per doctor. Bill another consultation!
consults
If the conditions for a consult are met: request, reason, report: then you can bill a consult because it's a different hospitalization. Consults are divided into outpatient/office and inpatient, not new and established.
If the patient was in the same admission, then only a subsequent hospital visit.
Some surgeons (and other specialists) only bill level 4 and 5 consults, because they were taught to do a comprehensive history and exam on every patient. Here's the perfect time to bill a level three consult, and add some variation into their profile. They may not need to do a comprehensive history and exam again. They could then bill a lower level consult.