I have a different understanding and interpretaion than my coworkers on billing consults in the hospital setting. They believe that as long as some one like a hospitialist or a primary care doctor has admited patient and writes an order, it is a consult. It does not matter how many times or how recent our specialist has seen the patient prior. I have example where the patient had chemo treatment a week prior ordered by our doctor, was admitted to the hospital for cancer dx. Hospitalist writes order for our doctor to see and was billed as a level four consult. I have been searching for documetation but I cannot find anything clear about consulting on established patient. They are meeting the three "R"s but this seems wrong. They claim that the hospitalist is the admitting and they are only a consultant in the hospital for most patients and are documenting in that manner. We all are looking at the same policies from Medicare and seeing different things.
I was taught that unless the patient has an unrelated problem than it is not a consult, but of course primary care can do a consult on their patient prior to surgery?
What guidelines are other clinics/providers using?
Thank you so much!!
I was taught that unless the patient has an unrelated problem than it is not a consult, but of course primary care can do a consult on their patient prior to surgery?
What guidelines are other clinics/providers using?
Thank you so much!!