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consult vs established pt

  1. #1
    Default consult vs established pt
    Medical Coding Books
    I have an established patient that we have charged a consult out for on their first visit. We have since seen them for other office visits and charged them out as est pt E & Ms. A new referring has referred this established pt to us for a visit. Can I charge this out as a consult or do I need to use the established codes?

    thank you for your help,


  2. #2
    Yes, you could bill a consult for this patient if the referring physician is asking your provider for advice, opinion, recommendations, suggestion, direction, or counsel in the evaluation or treatment of this patient. The referring physician anticipates continuing to treat the patient's condition.

    If the referring is requesting your physician to assume responsibility for management of the patient's care for that condition and doesn't expect to continue to treat the condition then an established patient visit would be appropriate.

    Hope this helps,
    Jessica CPC, CCC

  3. #3
    thank you for your help!!!!!!!!!!!

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