Inpatient Consult

lmsnyfla

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The more I think about this, the more confused I become !
Doctor performed sx 9/18/08.... post -op office visit 10/07/08 99024, dx: wound dehiscence.... admits pt to hospital same day.... Doctor does consult on 10/08/08 and sx on 10/09/08. How should the 10/08/08 consult be coded ? As initial inpatient consult 99251 or subsequent hospital care 99231 ? Or am I just totally off base here ? PLEASE HELP !!!!!
 

pjwalsh72

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Some clarification is needed. If I understand correctly, Dr A performed surgery on 9/18/08 which had a global period. (What was the code used for the surgery and what is it's global period?) Dr A saw the patient in follow-up on 10/07/08 and during that visit decides to admit the patient to the hospital on that same day. On 10/08/08 are you saying he consulted on his own patient? This would not meet consultation guidelines. He cannot request an opinion or seek advice from himself. If he saw the patient then he would charge a subsequent day.
 

lmsnyfla

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Doctor did an ORIF of the tibia 27536 which has a 90 day global period. Thank you, thank you, thank you !!!! As soon as you said he can't consult for himself, I realized my error. Thanks again for UN-confusing me !!
 

crasberry

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Inpatient consult question

I need to send a scenario to someone regarding the same issue. Please help if you can.
The department hires an internist to help with their inpatient. The attending from the department admits a patient and does the H&P. The internist (who is paid by the same department, billing area is the same) see's the patient for 3 days and then over the weekend the attending will see the same patient. Within the next few days the internist calls the same attending for a consult because he needs advice on the patient and the internist is not a hematologist. My concern is that this attending has already been seeing the patient. Can they be called in to consult even if he has been managing the patient under this hospital stay already?
 
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Crasberry asks: My concern is that this attending has already been seeing the patient. Can they be called in to consult even if he has been managing the patient under this hospital stay already?

No.

F Tessa Bartels, CPC, CEMC
 
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