coding consults

LLRodgers

Guru
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173
Location
Dayton, PA
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Hello,

Can anyone tell me how you code consults? Just read an article that said because Medicare does not pay for consults does not mean other Insurances will not pay for consults.

Do you code the diagnosis and then code a consult code instead of an E/M code or do you code both?

Sorry for the question but I have not code consults before

Thank you,
LLR
 

mhstrauss

True Blue
Messages
1,240
Location
Baton Rouge
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0
Hello,

Can anyone tell me how you code consults? Just read an article that said because Medicare does not pay for consults does not mean other Insurances will not pay for consults.

Do you code the diagnosis and then code a consult code instead of an E/M code or do you code both?

Sorry for the question but I have not code consults before

Thank you,
LLR


If the payer, such as Medicare, no longer accepts consult codes, you will use the appropriate new/established patient E/M code instead of the consult code. If the payer DOES still accept consult codes (here in Louisiana that includes all of the major commercial ins.), use a consult code. Either way, you have a have a diagnosis code; that does not change.

HTH!
 
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