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Thread: Need guidance

  1. #1

    Default Need guidance

    AAPC: Back to School
    Can an establish patient be seen for a consult? I am getting conflicting information from different sources.

    What if the consulting provider wants an opinion on a new problem?



  2. #2
    Join Date
    Apr 2007


    Yes they can do a consult on an established patient. You just need to meet the requirements for a consult.

    Medicare limits you to 1 consult per provider (or group) per hospital admission but other than that I am not aware of any other limitations.

    CPT states that it can be on the same problem or a new problem.

    Laura, CPC

  3. #3

    Default Thank you!

    Thanks Laura!


  4. #4
    Join Date
    Apr 2007
    Boston, MA


    As long as another provider asks for your provider's expertise for the problem, and this is clearly documented, then you could bill a consult - of course, the other requirements for consult must be met as well. The fact that the patient was previously seen does exclude a consult.

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