Wiki Inpatient consult?

[tcoder5]

If a patient is in the hospital and the attending is asking the oncologist to go see the patient because the patient is an established patient of the oncologist, this would not be a consultation, especially if the visit is for the same illness or a progression of the illness. If it were for a different illness would it be billed as a consult?

Thanks for any help.

 

[tjrice]

Consult

If a patient is in the hospital and the attending is asking the oncologist to go see the patient because the patient is an established patient of the oncologist, this would not be a consultation, especially if the visit is for the same illness or a progression of the illness. If it were for a different illness would it be billed as a consult?

Thanks for any help.

A consultation must be requested and documented in the record. The consulting physician must document the visit as such and send the findings to the requesting physician. Just because the attending asks the oncologist verbally and the oncologist goes to see the patient, if there is no documentation of the request it's a social visit.

 

[tcoder5]

Let me clarify. It was a consultation request. The question is that this is an established pt of the consulting physician for the same diagnosis that the physician has been treating the pt for so therefore I believe that this would not be billed as a consultation. Agree?

 

[OCD_coder]

Consultations are not new or established based codes, they are point of service based. They are specific to a request to a question needing answers by the requesting provider. An oncologist can provide a consult on their own established patients.

If the request was simply to notify the oncologist that their patient was admitted, this would not likely support a consult. The documentation needs to support the Consult codes, just realize this is only relevant for select commercial carriers only.

We cannot tell you yes or no without reviewing the documentation and the intent of the requesting physician.