Wiki Need guidance

[Love Coding!]

Can an establish patient be seen for a consult? I am getting conflicting information from different sources.

What if the consulting provider wants an opinion on a new problem?

Thanks!

dscoder74

 

[LLovett]

Yes they can do a consult on an established patient. You just need to meet the requirements for a consult.

Medicare limits you to 1 consult per provider (or group) per hospital admission but other than that I am not aware of any other limitations.

CPT states that it can be on the same problem or a new problem.

Laura, CPC

 

[Love Coding!]

Thank you!

Thanks Laura!

dscoder74

 

[Karolina]

As long as another provider asks for your provider's expertise for the problem, and this is clearly documented, then you could bill a consult - of course, the other requirements for consult must be met as well. The fact that the patient was previously seen does exclude a consult.