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Thread: Consult question

  1. #1
    Join Date
    Apr 2007

    Default Consult question

    AAPC: Back to School
    Hi Everyone.
    I have a consult question. Coding Pain Mgmt, we have an established patient, an inmate, who has returned for #2 in a series of 3 tranforaminal block. However, it was decided he would benefit more from facet blocks in the future. I see no request from the prision, or mention in dictation, for a new problem. Office has coded it as a consult because the request for a different procedure needs to be approved by the prision. Consult vs established f/u?
    Thanks for all the help.

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Established

    For a consult the request for advice or opinion must precede the service. In this case your physician is routinely following an established patient and has determined a new course of treatment is needed. He needs a referral from the prison but this is NOT the same as a request for a consult.

    F Tessa Bartels CPC

  3. #3

    Default established

    the doctor can perform, request procedures to be done. (new course of treatment). This would not be a consult, the doctor is following the care of the patient. This would need to be a precert/preauth needed for the procedures to be done. There is no request for opinion prior to the service or the established patient visit.

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