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Thread: Consults

  1. #1
    Join Date
    Apr 2007

    Default Consults

    AAPC: Back to School
    Is there a time frame on how many consults by the same physician can be billed during a certain amount of time. For example, a cardiologist saw a patient in consultation on 11/25/2009, and is being consulted again 12/30/2009 for a different reason. Is is okay to bill a consult within that small time frame?

    Thank you,
    Tiffany Fischer, CPC, CEMC

  2. #2
    Join Date
    Apr 2007


    Unless there is a particular insurance restriction, no there is no restriction.

    Medicare did have a restriction for inpatient consults, 1 per admit per provider/specialty of the same group. Obviously not an issue this year but I see your dates are last year.

    I do have some managed cares that restrict consults but we don't know about those until its too late and unfortunately the patient gets stuck with the bill.

    Laura, CPC, CPMA, CEMC

  3. #3
    Join Date
    Apr 2007

    Default Consults

    I didn't think there were any restrictions outside of inpatient, but I cannot find any documentation to support it. Do you have any direction to lead me to find the documentation?

    Thanks for your help!
    Tiffany Fischer, CPC, CEMC

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