Results 1 to 4 of 4

PAs and consults?

  1. #1
    Default PAs and consults?
    Exam Training Packages
    I'm getting caught up on the verbage in CPT about consults. “A consult is a type of evaluation and management service provided by a PHYSICIAN at the request of another physician or appropriate source” I interpret it to mean only a physician can perform the consult, but other providers can order a consult. The reason I ask is because I'm wondering if I can bill a consult for my PA or do I need to report subsequent hospital care codes. Since she didn't admit the patient I know I can't bill for the initial hospital care codes. Thanks in advance.
    CPC, COSC

  2. #2
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    As far as office visits go, Consults are not paid by Medicare. That said, some of the other insurances do pay consult codes for Midlevel practioners. I have just done research on this subject as I believe money could be lost because of the CMS rule.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. #3
    Location
    Swainsboro/Statesboro
    Posts
    673
    Default
    I agree with Karen.... I would try with the PA to submit the consult and see what happens, the PA did the work and you have the documentation...
    thanks, Sue
    Susan Edwards, CPC, CEDC, AAPC Fellow
    Swainsboro/Statesboro Georgia President

    smecoder@gmail.com

  4. #4
    Location
    Springfield, MO
    Posts
    17
    Default
    Quote Originally Posted by nrichard View Post
    I'm getting caught up on the verbage in CPT about consults. “A consult is a type of evaluation and management service provided by a PHYSICIAN at the request of another physician or appropriate source” I interpret it to mean only a physician can perform the consult, but other providers can order a consult. The reason I ask is because I'm wondering if I can bill a consult for my PA or do I need to report subsequent hospital care codes. Since she didn't admit the patient I know I can't bill for the initial hospital care codes. Thanks in advance.
    Actually, at least in my state, you can bill an initial hospital care codes because your admitting physician should have put an AI modifier on his initial hospital care code to indicate he/she was admitting physician.

    -AI Principal physician of record (Use this modifier to identify the the admitting physician of record who is overseeing the patient's care. This modifier will be used to distinguish between the admitting physician and other physicians who may be furnishing specialty care. The admitting physician will append this modifier to his/her initial hospital or initial nursing facility care.)

Similar Threads

  1. H&E and PAS-routine???
    By buppkl in forum Pathology & Clinical Laboratory
    Replies: 4
    Last Post: 09-19-2013, 12:09 PM
  2. PAs and Dr. diabetic footcare
    By sorcha48 in forum Podiatry
    Replies: 0
    Last Post: 01-21-2011, 11:22 AM
  3. Hospital Employed PAs
    By LLovett in forum Medicare Regulations
    Replies: 2
    Last Post: 01-26-2010, 12:55 PM
  4. Question about PAs
    By coder25 in forum E/M
    Replies: 2
    Last Post: 09-22-2009, 12:30 PM
  5. PAs and New Patient/New Problems
    By nikkisgranny in forum Orthopaedics
    Replies: 4
    Last Post: 09-15-2008, 05:12 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?

Login

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.