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Established patients as consults in patient

  1. Default Established patients as consults in patient
    Medical Coding Books
    An established patient of our group is admitted to the hospital by another physician. That physician, or another one caring for patient requests us to come in and consult on the patient. The patient has leukocytosis but we are seeing in hospital for a DVT. Can we bill as a consult since the patient is an established patient of ours, or should be bill 99221-3??
    If we bill for a progression of a known problem?

  2. #2
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    Quote Originally Posted by stullvs View Post
    An established patient of our group is admitted to the hospital by another physician. That physician, or another one caring for patient requests us to come in and consult on the patient. The patient has leukocytosis but we are seeing in hospital for a DVT. Can we bill as a consult since the patient is an established patient of ours, or should be bill 99221-3??
    If we bill for a progression of a known problem?
    They don't necessarily have to be a new patient to bill a consult, but be careful - You'll only use a consult code if it's a true consultation - the request for your doctor's opinion has to have been documented in the record, and your MD must have given a written summary of his findings/opinion back to the requesting MD. Also, the patient can't have Medicare; if they do, then you have to use the regular inpatient codes, anyways.

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