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Consult within Same Group

  1. #1
    Question Consult within Same Group
    Medical Coding Books
    If Dr. A sees a patient for 99251 (inpatient consult) and Dr. B sees the same patient on the same day for 90801 (initial psych eval) or any other service (i.e. 90862 medication mgmt), the Drs are within the same group, can they both bill?


  2. Default
    They are two entirely different specialties, so I would say yes, no problem.

  3. #3
    Thx! They are both Psychiatrists within same group but one has expertise in Geriatrics...still okay? I think so but want to make sure. Not sure where I can find guidelines on this? I didn't see anything on CMS.


  4. Default
    Just curious. Would the geriatric psychiatrist be managing non-psychotrophic meds? Why couldn't the geriatric psychiatrist totally manage the patient from both a psychiatric and geriatric standpoint? When you bill these services will you be able to distinguish the two specialties? I don't recall geriatrics as having a specialty provider code. You may want to check with your carrier before you submit your bill. Just my opinion.

  5. #5
    You can bill for the inpatient consult for Dr. A. And bill for the 90801 or 90862 for Dr. B. Now whether the payor pays for them or not is totally a different story. You may have to submit the documentation from both providers to show that they were two different reasons. Hope this helps!

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