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Billing a New Patient OV E & M along with a OV Consult Code

  1. #1
    Talking Billing a New Patient OV E & M along with a OV Consult Code
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    I have a provider that has billed an OV New patient CPT for the same date of service as a OV Consult Code. I do not believe this is correct coding. If the visit started out as a consult but the physician decided to take the patient on as a new patient I do not see where they should be able to bill the consult. Someone else says they could bill an established and a consult but I do not see that as valid either. Can anyone point me in the right direction.

  2. #2
    My guess...and this is an off-the-top-of-my-head guess your provider needs to pick either a consult or a problem E&M for that particular DOS. You can't bill a problem E&M AND a hospital E&M on the same day. I would think the same rule would apply to your situation.

    Becky, CPC

  3. #3
    Seacoast- Dover New Hampshire
    Also keep in mind, some payors do not pay for consults.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

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