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Wiki Repeat Consult Codes on same patient

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Texascoder64

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Is it ever appropriate to bill a consult code on a patient more than 1 time within a 3 year period ?

For example, the PCP sends a patient to us for a "rash", then patient returns at a later date for a full body skin exam. The provider stated that because we send a note back to the original referring Dr that should justify a consult code.

I feel that once the pt is established and we assumed care, then it become established for any future skin exams.

A payer has sent the provider an "educational" letter for repeat consultation codes on same patients, so I want to educate the providers on the appropriateness of billing office consultations.
Input from other specialist coders would be helpful.

Thank you
 
Only the actual consultation can be billed as a consult. Follow-up visits are billed as regular E/M.

I don't have a precise source, but I'm sure if you Google it, you can find something to show the providers.
 
I believe the provider has to actually write a formal letter/consultation letter in order to qualify for billing consultations. Just simply sending a copy of medical documentation to the referring doctor doesn't really count as extra work put in for a consultation.
 
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