multispecialty practice

francor

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Tequesta, FL
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if i have a new patient seen by an orthopedist in a multi specialty group and then refer to a pain physician in the same group do you bill a consult code, established patient or new patient?
 

csperoni

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Selden
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Consult 99241-9945 is only used 1) if all 3 Rs are met (request, render, reply) and 2) the insurance accepts consult codes. Very few carriers still allow these codes.

Per the CPT definition:
A new patient is “one who has not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice, within the past three years.”
The pain physician may bill a new patient, assuming he/she is credentialed as a different specialty from the referring physician.
 
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