Wiki 2010 Consults - NON MEDICARE

[tjudd]

Please bare with me....
In the 2010 CPT book it state "A consultation is a type of evaluation and management service provided by a physician at the request of another physician or appropriate source to either recommend care for a specific condition or problem or to determine whether to accept responsibility for ongoing management of the patient's entire care or for the care of a specific condition or problem"

So, my question is...as a speciality, really, most of our "consults" really are consults?? - I really am not liking consults!! -
Does this statement hold true?

It is a consult the first time the patient is seen. If treatment is started and is managed by your doc, all visits by your doc for that specific treatment are follow up E/m's. If you doc is asked for opinion regarding a different dx during that time of tx or after, he can bill the consult again.

Thank you!!
Tam

 

[FTessaBartels]

Yes this is the definition of consult per AMA

The AMA owns and produces the CPT book - NOT Medicare/CMS.

So yes, this is the definition per AMA.

Per CPT the provider being asked for a consultation has ALWAYS had the option to begin diagnositcs or treatment of the patient for the condition requiring the consultation.

Hope that helps.

F Tessa Bartels, CPC, CEMC