In Patient Consults VS Transferred Care


Cameron, NC
Best answers
Hello fellow Co-workers :)

I work in a multi-speciality clinic that does ORTHO, GYN, ENT, NEURO, URO, General Surg, and Vascular.

Say a patient is picked up as a result of an ER /admitt and the ER doc wants a Surgical opinion, we assume the care of the pateint as we took them to surgery. The attending admitted the patient already, they are IP status. Would We be able to bill the IP Consult or would this be Transfer of care?

I need your input and if you have any references to this for me to give my Physicians. We are doing Audits on Consults. IP is ?????

thank you

Kathy Hoffman CPC
North Carolina.
Milwaukee WI
Best answers
ER Consult

If I understand the scenario correctly ...
Patient presents to ER
ER doc requests surgical consult
Surgeon sees patient in ER, decides surgery required and takes patient to OR.
Patient is admitted to ? ... who is the attending - surgeon? PMD?

In the above outlined scenario, the requesting MD is the ER doc, and the consult and Decision for surgery took place in the ER. So this would be an OUTPATIENT consult 99241-45 w/ -57 (or -25) modifier, depending on whether surgical procedure was major or minor.

There would be no charge for initial inpatient admission, if the surgeon is the admitting MD because that would be global to the surgery ... The decision for surgery having occurred in the outpatient setting during the consult.

F Tessa Bartels, CPC