Wiki Consults

[tfischer]

Is there a time frame on how many consults by the same physician can be billed during a certain amount of time. For example, a cardiologist saw a patient in consultation on 11/25/2009, and is being consulted again 12/30/2009 for a different reason. Is is okay to bill a consult within that small time frame?

Thank you,

 

[LLovett]

Unless there is a particular insurance restriction, no there is no restriction.

Medicare did have a restriction for inpatient consults, 1 per admit per provider/specialty of the same group. Obviously not an issue this year but I see your dates are last year.

I do have some managed cares that restrict consults but we don't know about those until its too late and unfortunately the patient gets stuck with the bill.

Laura, CPC, CPMA, CEMC

 

[tfischer]

I didn't think there were any restrictions outside of inpatient, but I cannot find any documentation to support it. Do you have any direction to lead me to find the documentation?

Thanks for your help!