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Consult help please

  1. #1
    Default Consult help please
    Medical Coding Books
    When a consult is requested, does the physician the request was for have the right to delegate that to another provider and still bill a consult?

    My scenario is that a patient is in the hospital and develops cardiac issues, the hospitalist requests the CVT surgeon to come evaluate the patient. The CVT surgeon sends his PA to see the patient.

    My feeling is this is no longer billable as a consult but I need something to either support that or say that it is ok for the PA to bill a consult when the request was actually for a different provider to see the patient.


    Laura, CPC

  2. #2
    Milwaukee WI
    Default Scope of practice
    If the PA's scope of practice allows, then you may bill the consult under the PA's name.

    You cannot bill under the CV surgeon's name.

    F Tessa Bartels, CPC, CEMC

  3. #3
    I appreciate the response but that part isn't in question, I should have worded it more clearly to indicate the PA would be billing the consult.

    My scenario happens to be a doctor to a physicians assistant but that isn't always the case.

    The base question is if a consult is requested of a specific individual, and that individual does not see the patient but someone else does, can that provider bill it as a consult even though their opinion was not requested?

    The requested provider is onsite and availble, so this isn't an issue of someone covering for him.


    Laura, CPC

  4. Default
    if the pa is of the same service /billing area as the surgeon which i am assuming they are--then i would say yes this is a consult.

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