Ok, scenario 1 doesn't sound like a true discharge but a transfer to another facility to continue the same admit. The CMS rule was one consult per provider per admit. CMS no longer covers consults and I am not aware of any commercial carriers having this rule (aside from the ones that follow CMS guidelines). So depending on the carrier you could have a 2nd consult in this case.
The next issue is, is it really a consult or are they asking them to come manage this issue. It sounds to me like co-management in both scenarios 2 and 3 and possibly 1. In that case you don't have a consult at all but a transfer of care.
Laura, CPC, CPMA, CEMC
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