Consultation in hospital

carol ann

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If a surgeon operates on patient and admits patient to hospital. The surgeon then request the primary Dr. to consult and treat the patients ongoing medical problems. Can the primary Dr charge a initial consultation for seeing the patient the first time? After the initial consult what type of E/M should he charge?

Next part of the question: If other doctors in the same pratice as the patients primary doc see the patient, can they charge a initial consult for there first time to see the patient or do they charge a subsequent hospital visit?
 

Lisa Bledsoe

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Sounds more like the surgeon is asking the PCP to take over management of medical problems...therefore it would not be a consult. The surgeon would not be treating the medical problems - my opinion is a hospital follow up for the PCP. If another doctor in the same practice as the PCP sees the patient it is a hospital follow up code.
 
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The Surgeon is asking the PMD to consult

IF, in fact, the surgeon is asking the PMD to consult, then, yes, the first inpatient visit would be a consultation (all the bullet points need to be met to determine the level); any additional inpatient visits by the PMD (or any of his/her partners in the same practice) would be subsequent hospital visits. Even if the PMD decides to continue to treat and manage the medical issues for which the consult was requested, the first inpatient visit would still be a consult, IF that's what the surgeon requested.

But, as Lisa points out, if the surgeon is asking the PMD to manage the patient's on-going medical issues, then all the visits are subsequent hospital visits.

F Tessa Bartels, CPC, CPC-E/M
 

jeanyves

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Take care with reporting consult codes at any time if intent is in question- Consultation is for opinion or advice-if intent is that Dr is to take over a portion of the care and continue during that hospitalization- transfer of care is in question (even a taking on only the condition can be transfer of care) transfer of care is not a consult. Just because the requesting Dr calls it a consult there are rules to the use of this type of coding I would never assume this is a given.

Hopefully this helps
 
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