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Billing a concult code while still in Global.

  1. Default Billing a concult code while still in Global.
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    are you allowed to bill a consult code, if the physician is called to consult in the ER for a patient he has performed surgery on in the previous month?

  2. #2
    Location
    Hartford, CT
    Posts
    723
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    If it's for a different problem then yes and you would use a modifier 24.

  3. #3
    Location
    Concord, NC or Rochester, NY
    Posts
    154
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    Is it the same problem or a different?

    If the same, is it necessary to go back to the OR?

    If not the same problem (diagnosis) the answer is yes.

    Global is only for the surgery performed.

  4. #4
    Location
    Tacoma, WA
    Posts
    1,087
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    Quote Originally Posted by messinar View Post
    are you allowed to bill a consult code, if the physician is called to consult in the ER for a patient he has performed surgery on in the previous month?
    The ER doctor is not requesting a "consult", what the ER doctor generally wants the consulting provider to assume care management for the patient. Your provider got the request and rendered the service, but there is not a written report back to the ER doctor.

    Your provider would bill an E/M service code for the site of service, whether it was in the ER or if he admitted the patient to the hospital.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  5. #5
    Location
    Concord, NC or Rochester, NY
    Posts
    154
    Default
    The written report can be part of the hospital chart. The posing questions does not indicate the consult is to take over the service - so it depends on whether it is a transfer of service or truly looking for an opinion.

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