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99204 vs. 99244

  1. Default 99204 vs. 99244
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    If the pt was referred to a specialist and we do a initial consultation should we charge a new pt or a consult i.e. 99204 vs. 99244? (non-MCR pt).



  2. #2
    Columbia, MO
    It depends on if the patient was referred to your physician or did the initial physician request a consult from your physician.
    Remember to be a consult all 3 of the 3 Rs must be met
    REQUEST - you must have documentation that a request was generated
    RENDER - you must have documentation to support that the request was asking your physician to render back an opinion or a decision about an issue that is unknown or ill defined or is causing them a problem.
    REPORT - you must have a copy of the formal dictated report that was sent back to the requesting physician, detailing your findings and suggestions.
    If the intial physician requested that your physician take over management of the patient for a problem already defined then it is not a consult.

    Debra A. Mitchell, MSPH, CPC-H

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