Results 1 to 2 of 2

Billing Consult day before surgery

  1. Default Billing Consult day before surgery
    Medical Coding Books
    Scenario: Cardiologist sees a patient and refers him to an EP physician. The EP physician sees the patient does your standard level 3 or 4 consult and then tells the patient that he will need to schedule him for the test. Patient has the EP test the next day.

    Physician is being told that he cannot bill the consult because it is within 3 days of the procedure. (some 3 day rule I have not heard of) EP does not have a 90 day global so why is the doctor being told this?

  2. #2
    Who is telling the physician this? Is this some weird insurance rule? And what is the patient scheduled for? a "diagnostic test" or "surgery"? The title of your post says surgery and in the post it says test, so I'm not sure. I've never heard of a "3 day rule" The EP doc should bill his consult accordingly, and IF the test is a physician service, he should bill for that too. IF it's "surgery" and the "consult" was the "decision for surgery" then you should put modifier 57 on the consultation.

Similar Threads

  1. billing consult same day as surgery
    By tward01 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 01-20-2015, 09:29 PM
  2. Consult w/ Same day Surgery
    By Cvreeland in forum OB/GYN
    Replies: 1
    Last Post: 09-18-2012, 02:11 PM
  3. Inpatient consult billing outside surgery global
    By candicane1010 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 12-24-2009, 10:45 AM
  4. Consult billing on same day as Moh's Surgery?
    By Jen Verlinda in forum Dermatology
    Replies: 6
    Last Post: 06-09-2009, 03:53 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.