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Need assistance with consult orders

  1. Angry Need assistance with consult orders
    Medical Coding Books
    I'm need some assistance with who is "right or wrong" in a senario in our practice. We do hospice/palliative medicine and our MDs/NPs do palliative care visits/consults on patients who do not qualify for hospice services.
    My concern is that one of our clinical marketers is getting "blanket consult" orders from SNFs in the area in order to "watch" the patient and be able to admit them in to hospice services once their Medicare A days are up at the facility. She is telling the SNF MDs that if they just give us an order for "disease progression and symptom management" that we (our MDs/NPS) will visit the patient once a month or more often and "keep an eye on them" until they are aready for hospice. She has brought in at least 4 "consult orders" with this exact same terminology used on every one of them....she might as well go ahead and just run a bunch of copies!
    ....Sorry I'm just way too uncomfortable with this!!! 1) To me it's not really a consult request, because what are they going to do about disease progression...nothing because if they are hospice appropriate, there's not a thing they can do to change that and what symptom are they wanting us to assist with???? 2) These orders are being asked for by the marketer from the supposely referring MDs office?! Isn't a consult where the referring MD asks our group for the visit not us asking them?!
    Any advice would be greatly appreciated!! I'm being told that I am being too strick and that getting patients in the program is more important.

  2. #2
    I don't think there is a problem with seeing the patients and helping to get them in the program.

    I do have a problem with charging a consult code. They don't want an opinion, they want a green light.

    I say see the patients, do what is medically justified, then bill either a new patient or established patient E/M based on documentation.

    Just my opinion,

    Laura, CPC

  3. #3
    Milwaukee WI
    Default Not consults
    I agree with Laura. These are not consults. They are referrals.

    F Tessa Bartels, CPC, CEMC

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