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Er consult

  1. #1
    Smile Er consult
    Medical Coding Books
    couple different questions....

    dr does and er consult and admits the pt then does surgery the same day.. I would use the 99221-99223

    dr does an er consult and recommends the pt go home and doesn't need to be admitted. would you do an outpt consult? or an emergency department visit?

    what if your payer is medicare?

    Just when you think you have it down... then the drs question it.... (sigh)

    Thanks!

  2. #2
    Default
    just to add a little bit.... because I got the report....

    Requesting Physician : Dr. Smith

    Reason for consult: RLQ pain

    H&P, past medical hx, medications on admission, allergies, fh, sh, review of systems, past surgical hx, physical exam lab studies, rad imaging, impression: constipation, i spoke to the pts wife and pt about changing his bowel regimen somewhat. Add fiver to his diet. Make a follow up appointment w/ dr Jones later this month and address a colonoscopy. I suggest he follow up w/ his pcp.


    so he is seeing them? and not just doing a consult....

  3. #3
    Location
    Milwaukee WI
    Posts
    4,466
    Default Not sure I understand ...
    Quote Originally Posted by laura_clffrd@yahoo.com View Post
    just to add a little bit.... because I got the report....

    Requesting Physician : Dr. Smith

    Reason for consult: RLQ pain

    H&P, past medical hx, medications on admission, allergies, fh, sh, review of systems, past surgical hx, physical exam lab studies, rad imaging, impression: constipation, i spoke to the pts wife and pt about changing his bowel regimen somewhat. Add fiver to his diet. Make a follow up appointment w/ dr Jones later this month and address a colonoscopy. I suggest he follow up w/ his pcp.


    so he is seeing them? and not just doing a consult....
    I added emphasis to your statement to show what is confusing me about your question. Do you believe that a consultation does NOT require a face-to-face service, including exam?
    Or are you thinking it is not a consult because he is asking that the patient make an F/U appointment?

    A consultation is a face-to-face service that requires ALL three key elements - history, exam and MDM.

    Medicare (and certain other payers) no longer recognizes the consultation codes. If the patient is covered by Mecare (or another payer that doesn't recognize the consult codes), then you must use a different E/M code ... ER visit, initial hospital visit, outpatient established (or new), etc.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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