Results 1 to 3 of 3

Consultation Coding ?s

  1. Post Consultation Coding ?s
    Exam Training Packages
    Can a specialist bill a consultation if a patient is required to attend a seminar explaining the process for certain procedures before scheduling an appointment with the specialist?

    Would it be appropriate for the specialist to contact the primary care provider (PCP) after the patient attended the seminar to ask the PCP if they would like the specialist to see their patient in consultation to give their advice and opinion regarding which procedure option is most appropriate and then bill a consultation for this service?


  2. #2
    A consultation takes place when a provider requests another provider see their patient for a specific problem then give their opinion or advice on how the requesting provider should treat the problem.

    The situation you are describing is a transfer of care, which is coded as a new or established patient code depending on the patients status with the provider.

    I'm not sure what procedure you are dealing with but it sounds similar to the way they handle bariatric surgeries. The PCP doesn't do those, if they send a patient to a seminar and then a surgeon that does it is with the intent the surgeon deal with the problem, not tell the PCP how to deal with it. Even if the surgeon decides the patient should not have surgery and sends them back to the PCP, the intent is what drives a consult not the outcome. If you don't have the intent you can't ask for it and you can't bill a consult.

    Hope this helps,

    Laura, CPC, CEMC

  3. #3
    Columbia, MO
    I agree with Laura, could not have said it better!

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Consultation coding
    By ibtrazy2u in forum E/M
    Replies: 5
    Last Post: 03-25-2015, 04:49 PM
  2. Consultation coding issue.
    By kahodges in forum Billing/Reimbursement
    Replies: 7
    Last Post: 08-28-2014, 10:09 AM
  3. Consultation coding
    By lpowell67 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 06-05-2014, 11:15 AM
  4. Consultation coding
    By smillar in forum E/M
    Replies: 3
    Last Post: 02-25-2008, 11:17 AM

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.