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Consult or established pt visit

  1. #1
    Unhappy Consult or established pt visit
    Medical Coding Books
    I work for spine surgeons and we also have three physical medicine & rehab. docs. in our practice that does all the conservative treatment . My question is, If a patient comes in and visits the PMR doc. and the PMR doc refers the pateint to the surgeon, would the surgeon office visit be established or a consult?

  2. #2
    Depends on the intent.

    If there is just a transfer of care (which is indicated by the word refer) it would be a new patient(if they have not seen another spine surgeon in that group within 3 yrs), because they are different specialties. If they had seen one of the spine surgeons in that time frame it would be established.

    If it is a request for opinion then you would have a consult if the 4 R's are met.

    Laura, CPC

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