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Consult versus Vcode

N

NESmith

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309
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Zephyrhills, FL
I know that the consult codes are no longer valid but this is for a DOS in 2009My doctor says he can not bill a consult code with a V dx code I think this is incorrect. Please advise Thanks
 
No you cannot do a consult with a V code. I have accidently sent a couple through and they always get denied. I guess the best way to look at it is why does the referring physician need an opinion from your doctor on family hx of colon cancer? Doesn't really make sense. Hope this helps!
 
First yes you can use a V code for any visit including a consult but it may not be paid due to medical necessity. I agree that a consult due to family history alone is a little strange unles you are a genetics specialist in which case it is perfectly fine. If you are trying to bill an office visit for a colonoscopy then no you cannot do that as any flavor of encounter when the PCP has requested this be done.
 
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