• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Is it appropriate to code a consult?

Create Wiki
M

micki127

Guru
Messages
148
Location
Derry
Best answers
0
Hello,

Is it appropriate to bill a consult in this suituation:

A patient that was seen at an Urgent Care facility is sent for a consult at an orthopedic facility. The criteria of the 3 R's would be met. Does that seem right that a patient is sent for a consult from a urgent care facility? It sounds like it should be more of a follow up appt. What is your thinking on this? Could you bill a consult in that situation if the 3 R's are met?

Thanks in advance.
 
If the patient was sent to the orthopedist from an Urgent Care I would say that this is not a consult. An Urgent Care is basically like an Emergency Room where the doctors take care of the patient's immediate need and then sends them back to either their own physician or a specialist. They do not do any follow-up care so they are not asking for another physician's opinion, which is a requirement for a visit to be considered a consult.
 
Thank You

Thank you for your advice! I agree that it should not be considered a consult. I just needed some reassurance:)
 
To further back up the opinion of 'not a consult': is the ortho cc-ing the exam notes to the urgent care? Is there anything in the records stating 'Dear Dr so-and-so, thank you for letting me see your patient...'. If there is nothing of this nature, then the consult code would be incorrect.
 
You must log in or register to reply here.
Top