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Thread: Consults

  1. #1
    Join Date
    Apr 2007

    Default Consults

    AAPC: Back to School
    We have two doctors that are in the same practice and same specialty. Dr. A did an inpt consult at the request of the admitting md upon admission. The patient was in the hospital for a long time. The patient developed a totally new problem and dr. B was requested to see patient. We billed consults for both doctors and the second one is being denied by medicare. I know that doctors from the same group cant bill more than one consult during same admission, but does it matter if there is a totally knew problem?

    Thanks for the help

  2. #2
    Join Date
    Apr 2007

    Default Consult x 2

    Unfortunately only one consult per admission per provider/group even with a new problem.

    Michele R. Hayes, CPC, CPMA, CEMC, CGIC

  3. #3
    Join Date
    Apr 2007

    Default consult

    Per the guidelines, only one consultation should be billed per admission.

    However, I do not know of any rule or reason why the second provider should not bill an appropriate inpatient level of service (99221-99223), supported by the documentation for the service provided.

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