Wiki Code ESRD 90960 with consult

[sadiaduquette@gmail.com]

Hi everyone,

I have someone questioning if you can bill for a consult by the same DR when the patient comes in the ER during the same month as billing 90960. Can't find any info pointing that we can't but just doesn't feel correct.... Any help?

 

[Chelle-Lynn]

Part of the definition for 90960 includes:

"The physician or other qualified health care professional also establishes, monitors, and coordinates care, which may include social service interventions, nutritional support, kidney transplant planning, and services provided by other medical and/or surgical specialists"

and

"The patient is examined on a routine basis for existing and potential medical problems, and is seen as needed when new symptoms or problems develop."

Based on this description, it would appear that ER consults would fall under the 90960 code.​