Wiki Readmission of est. pt to hospital weeks apart.

[ering2002]

We had a patient seen in consultation at the hospital back at the start of October. That same patient has been readmitted into the hospital for the same condition now in November. Can we bill another consult code even though it's already our patient and it's a new visit? Or do we have to just view it as a followup visit. Added inofrmation, we have yet to see this patient in the office. We have only seen this patient in the hospital.

 

[juliabiz@hotmail.com]

In the CPT 2011 Professional Edition, under Inpatient Consultations, New or Established Patients, it states "Only one consultation should be reported by a consultant per admission." I would think you could use a new consult code, since this is a new admission to the hospital. I could be wrong. See page 19 of the 2011 CPT. This is my best guess.

 

[dclark7]

The real question is, was your doc asked to do another consult or was (s)he just notified of the admission because (s)he had seen the pateint during the prior admission? If the provider was asked to do a consult then you can bill one since this is a deifferent admission. If the office was notified that the patient had been readmitted with no request for a consult, then no, you cannot bill a consult.