AAPC - Back to school
Results 1 to 6 of 6

Thread: H&P VS Consult

  1. #1

    Default H&P VS Consult

    AAPC: Back to School
    I have a physician who performs a consultation in the office and dictates to the hospital line and adds a note's that this also serves as the H&P for patients upcoming procedure. I have been billing for a office consult. Is this correct?
    Thanks for your help in advance.

  2. #2
    Join Date
    Apr 2007


    do you have a copy of that consult letter in your chart at the office?

  3. #3


    Yes we keep a copy in the chart and he also sends it out to the rquesting..

  4. #4


    That's the way our practice has been told to handle this situation. Just be sure that your consult documentation requirements are met.


  5. #5


    Thank you for your help,

  6. #6


    I would bill it as a consult if, 1st there is a request from the surgeon, verbal or written, a written answer to the surgeon concerning the findings in our chart and then most importantly, the consult was done because the surgeon required the expertise of my doc to determine that the patient was able to have the surgery. If the patient was say 25 with no ailments and going into surgery to have a fracture fixed I would not bill a consult code, just an H&P. There is really no need for an expert opinion with this patient. However if I had a PT with CAD or HTN, then I would bill the consult code, the surgeon is requesting the expertise of my doc as to whether the patient is able to undergo the surgery. His written report would advise the surgeon of his findings. There are some good articles concerning this on the CMS site if you would like to review this more. The following is from there:

    "A preoperative consultation at the request of a surgeon is payable if the service is medically necessary and not routine screening;"

    The medically necessary part is what I look out for. Hope this helps.

    Kate, CPC

Similar Threads

  1. Consult or E&M
    By tdybear829@aol.com in forum Medical Coding General Discussion
    Replies: 4
    Last Post: 03-20-2013, 10:42 AM
  2. consult vs established E& M
    By scochran1 in forum Cardiology
    Replies: 3
    Last Post: 02-18-2010, 08:50 AM
  3. Consult versus H&P
    By Juliette0416 in forum Modifiers
    Replies: 8
    Last Post: 08-05-2009, 09:23 AM
  4. Consult called for I&D
    By Trendale in forum General Surgery
    Replies: 2
    Last Post: 07-15-2009, 02:17 PM
  5. Neurology E&M Consult
    By ldeblaay in forum E/M
    Replies: 2
    Last Post: 02-21-2008, 05:38 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.