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Wiki consult vs established E& M

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sdunaway1

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Would you bill out a consult code for a surgery clearance or would it be more appropriate to use an E & M code? i have done both and been paid on both.
 
scochran1 said:
Would you bill out a consult code for a surgery clearance or would it be more appropriate to use an E & M code? i have done both and been paid on both.
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Well it would depend on a few things, if it's a medicare pt, you wouldn't worry about billing the consult codes since they are no longer valid. On the other insurances, on the ones my docs do, if the pt is a new pt to our practice and they did a full workup, we bill the consult. If the pt is established with us and they have current test's that were performed then we bill the established E&M code.

Hope that helps :)
 
Pam, CPC

We bill a consult code if it is not Medicare and the PCP is requesting cardiac clearance. A report has to be sent back also.
 
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