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  1. #1
    Evansville Indiana
    Default consult?
    Medical Coding Books
    Here is the scenario. We have differing opinions on whether these type of visits should be new patients or consults. A hospital employs sub-specialists from out of town who come in once a month or so to see patients. Patients primary care doctor thinks child is autistic or asthmatic, etc., sends child to subspecialist to diagnosis and treat the condition. Consult or referral? Any documentation to back up would be appreciated.

  2. Default consult vs. ref
    because the physician is clearing stating that he/she would like the specialist to dx and treat the patient, the visit is a referral (transfer of care). If the doctor was only asking the opinion of the specialist then it would be considered a consult.

  3. #3
    Evansville Indiana
    Default consult
    I totally agree, but the doctors are really fighting us on this because their home office and hospital compliance department is telling them that these are consults.

  4. #4
    Quote Originally Posted by cheermom68 View Post
    I totally agree, but the doctors are really fighting us on this because their home office and hospital compliance department is telling them that these are consults.
    I agree with you, is there any chance of you speaking with the hospital compliance dept, I'm pretty shocked that this info is coming from that dept in the first place.

    What you have described and documented clearly states a transfer of care, they are not wanting their opinion they are wanting them to treat this pt. In my opinion if this was a true consult the "consulting" doctor would not be treating the pt but just sending back his opinion.
    Roxanne Thames CPC, CPC-I, CEMC

    "Remember the greatest gift is not found in the store but in the heart of true friends"

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