Wiki Inpatient consultation

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Houston, TX
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Hi again,

I actually have another question for you all. Would the consultation guidelines (the three R's) apply to an inpatient status patient? Does the physician have to send a reply to the requesting physician if the patient is inpatient? Please help! This has been an on going discussion among my team.
 
Yes, the same requirements apply. If you look in the CPT book, it discusses what a consultation is and the documentation requirements on page 19. After that, the CPT book adds additional instructions based on the place of service (Outpatient vs. Inpatient) but the definition and documentation requirements would still apply in either case.
 
Thank you! That is exactly what I have been stating and it has been a back and forth situation. The argument being, how are they going to send a reply letter when the documentation is in the chart or they discuss the patient with the requesting physician.
 
In our practices, we don't require a separate written report when the requesting and consulting providers share our EHR. The consulting provider electronically routes their note to the requesting provider and we accept that. However, if the requesting physician is not within our system, we do look for a letter or fax sent.
And remember, while the consult request can be verbally communicated and recorded in the patient's chart, the consult report has to be written to report the Inpatient & Outpatient Consult codes. It can't be a verbal communication between the providers.
 
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