AAPC - Back to school
Results 1 to 2 of 2

Thread: Consultation by PCP

  1. #1
    Join Date
    Apr 2007
    Columbus GA

    Question Consultation by PCP

    AAPC: Back to School
    Can the PCP bill for a consultation when seeing the patient for a surgical clearance?

  2. #2
    Join Date
    Apr 2007
    Nashville AAPC Chapter


    Yes they can, a consultation is a request for an opinion. Medical clearance is an opinion as to whether they are fit enough to have the procedure performed. They must follow the three R's of a consultation though.
    1. Receive a request (documented in the chart that a formal request for an opinion is made)
    2. Recommendations: list of findings of the exam.
    3. Report: send a report back to the requesting physician.

    Caveat: I see many physicians over bill in this area and bill level 5's when the surgery being performed is not high risk. Example: If the patient is getting a knee replacement, the risk is moderate and probably warrants a level 4 consult. If the patient is going to have open heart surgery, this would warrant probably a level 5 consult. I see EKG's ordered as standard protocol whether or not the patient has heart issues and this is abuse of the situation.

    But every encounter is open to interpretation.

Similar Threads

  1. PCP sees pt in ER
    By tlwhlw in forum Emergency Department
    Replies: 4
    Last Post: 09-27-2012, 04:59 PM
  2. Consultation by PCP?
    By Rebecca Pate in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 09-06-2011, 02:23 PM
  3. EC doctor calls PCP and PCP wants admit
    By jazzinaro in forum Billing/Reimbursement
    Replies: 1
    Last Post: 04-01-2011, 09:47 PM
  4. Pcp Vs Ob What Can My Pcp Charge
    By smcglin in forum OB/GYN
    Replies: 1
    Last Post: 08-30-2008, 11:02 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.