We have a new physician who is asking if they see a patient of another doctor (at the same practice) for say a female pap, pevlic and breast exam because this doctor is a female & the normal doctor is a male..can she charge a the visit as a consult? My feeling and opinion is "no" as they are credentialed the same and there is not a particular medical problem for the use of a "consult" code. Am I correct? Does anybody know?
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Wiki consult question
- Thread starter gfreese
- Start date
tamerlane
Guest
Consult
By definition of a consult, NO.
By definition of a consult, NO.
EARREYGUE
Guru
I would say no since our CPT books state "A consultation is a type of service provided by a physician whose opinion or advice regarding E&M of a specific problem is requested by another physican or other appropriate source. "
Due to the sex of the physican is no reason to bill a consult. I would not image the doctor would write a written request for a consult due to his or her own sex. I believe this is not a valid reason.They can bill a preventive visit if that is preformed otherwise it would be an established patient 99211-99215.
However this is just my thoughts.
Due to the sex of the physican is no reason to bill a consult. I would not image the doctor would write a written request for a consult due to his or her own sex. I believe this is not a valid reason.They can bill a preventive visit if that is preformed otherwise it would be an established patient 99211-99215.
However this is just my thoughts.
zaidaaquino
Guru
Also, let's say the first doctor had requested a consult from another physician within the same group, the consultant must have expertise in a specific medical area beyond the requesting professional's knowledge. This is per Medicare's guidelines.
Zaida, CPC
Zaida, CPC
RebeccaWoodward*
True Blue
Nicely pointed out Zaida. An example of this would be in the Orthopedic arena. Both may be Orthopedic surgeons but one has a sub-specialty in Hand Surgery.