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Wiki Consultations

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Lyn123

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Can a new consultation code be billed if the the patient was seen over 3 years ago and is now sent back for consult, does it depend on payer
 
IF the payor accepts consult codes, you can definitely bill as 9924X. The consult codes specify NEW or ESTABLISHED pt. It does not matter how long since the patient was last seen provided it meets the requirements of consult (documented & referred by another clinician; report back to referring, etc).
If the payor does not accept consult codes, you can bill as new 9920X since it has been > 3 years.
 
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