Wiki Consultations

[nancymoorhead]

I need an opinion about an oncologist charging a patient for a hospital consultation and then seeing her in his office two weeks later and charging for an office consultation. Is thisincorrect? I believe that the oncologist can only charge one consultation code, not two. Someone, please give me some help with this.

 

[LLovett]

There would have to be a 2nd request for their opinion.

Most likely this is incorrect. This is the kind of stuff that keeps consults on the OIGs radar and will probably cause CMS to stop paying on them next year.


Laura, CPC, CEMC

 

[Karolina]

Well said, Laura.
It looks like there was a consult done and two weeks later the patient came for follow-up and/or specialist care (established patient).
A second request for another opinion is certainly a possibility, e.g., if the patient is cared for by the PCP and s/he requests the onco opinion to make sure tx is working etc., however - after such a short period very unlikely.
What does it look like in the documentation. Usually, the note for a consult reads quite different from a follow-up.