Wiki Consults

[PKellogg]

I work for a cardiologists office and am questioning coding consults. We are an off site facility of a hospital. If our Dr is seeing a pt for a consult who is an inpatient what CPT codes should they be coding with? There is a big discussion going on in our office.

 

[Orthocoderpgu]

I'm glad that your office is bringing up this topic because it needs to be understood. Just because your doctor is asked to see a patient does not mean it's a "Consult". As a matter of fact "Consultations" are almost never performed so much so that CMS stopped paying for consultation codes and now most private insurance companies have followed their lead. While your doctors may be using the term "Consultation" I can tell you that they are not performing or documenting them. Here is some very good information on actual consultation coding and documenting.

https://www.aapc.com/blog/24816-consult-or-not/#:~:text=CMS%20guidelines%20allow%20for%20same,patient%20as%20a%20routine%20practice

 

[poojagujar@hotmail.com]

I work for a cardiologists office and am questioning coding consults. We are an off site facility of a hospital. If our Dr is seeing a pt for a consult who is an inpatient what CPT codes should they be coding with? There is a big discussion going on in our office.

It is payer-specific and we created an excel spreadsheet with all the payers to show which payers will allow consult codes and which ones do not.

 

[Orthocoderpgu]

It is payer-specific and we created an excel spreadsheet with all the payers to show which payers will allow consult codes and which ones do not.

When you bill a consultation to an insurance that will still pay on them, are you meeting all three documentation requirements of a consultation?

 

[PKellogg]

When you bill a consultation to an insurance that will still pay on them, are you meeting all three documentation requirements of a consultation?

Is this a spreadsheet that can be shared with us?

 

[PKellogg]

It is payer-specific and we created an excel spreadsheet with all the payers to show which payers will allow consult codes and which ones do not.

Is this a spreadsheet that can be shared?

 

[omgzchristie]

Is this a spreadsheet that can be shared?

Yes, please share if possible! Thank you