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Wiki Consult w/ Same day Surgery

C

Cvreeland

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Fredericksburg, Virginia
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We had a patient that was sent to us for a consult by PCP. The OBGYN doctor gave the consult and then did the surgery all in the same day. They are documented separately. Can I bill this as a consult or is this an E&M, transfer of care.
 
You can bill a consult if: 1) the patient's insurance carrier allows consults vs E/M codes and you do in fact send back a report to the referring physician 2) You append the 57 modifier to that code even if on separate claim to show the decision for surgery was made and it is not included in the global period.
The way I understand the rule, you are not assuming care of the patient from the PCP; they will be returning to him/her for continuing primary care.
 
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