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consult vs established E& M

  1. #1
    Default consult vs established E& M
    Medical Coding Books
    Would you bill out a consult code for a surgery clearance or would it be more appropriate to use an E & M code? i have done both and been paid on both.

  2. #2
    Location
    Jacksonville Florida
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    Default
    Quote Originally Posted by scochran1 View Post
    Would you bill out a consult code for a surgery clearance or would it be more appropriate to use an E & M code? i have done both and been paid on both.

    Well it would depend on a few things, if it's a medicare pt, you wouldn't worry about billing the consult codes since they are no longer valid. On the other insurances, on the ones my docs do, if the pt is a new pt to our practice and they did a full workup, we bill the consult. If the pt is established with us and they have current test's that were performed then we bill the established E&M code.

    Hope that helps
    Jammie Barsamian, CPC, CCC, CEMC, CCS-P, CPMA

  3. #3
    Default Pam, CPC
    We bill a consult code if it is not Medicare and the PCP is requesting cardiac clearance. A report has to be sent back also.

  4. #4
    Default
    thank you for all of the help on this!!!!!!!!

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