Well... first off, you say "consult" I do not deem this a consult. Normally the ER physician calls in a "consultant/specialist" but they are not requesting the advise/opinion/expertise of this provider. They are simply "passing the buck" as it's beyond their level of expertise... SO, if the gastro doc that saw your husband billed a level 4 consult, 99244 or 99254. This is incorrect already. If your husband was inpatient, they should have billed a subsequent care code, 99231-99233. If your husband was outpatient, the gastro should have billed 99201-99215. If the gastro admitted him, he should have billed 99221-99223.
Ok, so, with that said. The next issue... NO the consultant CANNOT use another physician's documentation as their own. They would have to redictate the ROS, PFSH.. and do their own exam. How could a gastro use a ER doc's exam? I certainly would be upset if I had a gastro work up and they used the ER doc's exam because then WHY was gastro called in... there's obviously an issue/problem at hand that the gastro would have to check/exam himself in order to give an accurate assessment/diagnoses. Furthermore, this degrades quality healthcare.
Now as far as what should have actually been billed by the gastro, I would like to see what he documented... is there anyway you could post his note? (names removed of course)
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