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Need Opinions!! Consults.

  1. #1
    Default Need Opinions!! Consults.
    Medical Coding Books
    I was in another thread about this and want to know what everyone thinks. This is always a hot debate in our office.

    When an ER physician - calls a service, such a gen surg, plastics, cardio, etc....... how does everyone code this if the service called doesn't admit the patient?

    i.e. : patient is in observation or in ER, do you bill outpatient consults (99241-99245) or outpatient codes whether they are new or established? (99201-99215)
    Last edited by ARCPC9491; 09-05-2008 at 09:06 AM.

  2. #2
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    Greeley, Colorado
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    Default
    If the patient is not an established patient with the service called and the doctor renders his/her opinion and reports to the ER doc who then discharges the patient from the ER, wouldn't that be a consult? I realize that an ER doc would not normally see the patient back after the consult, but if the "consultant" renders/reports the opnion and leaves the ER discharge to the ER doc, it seems like a consult to me...
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Default
    Agree w/ you! but if the consultant sends them home.. this is where it gets debatable.. and if the consultants sends them home, I say no consult. two other people at my office say consult even if the consulting sends home.. Is there any literature on this somewhere??

  4. Default consults
    sorry to throw this in but if a physician sees the patient for an inpatient consult and does not see the patient in the hospital after the consult but then a week or two later the patient comes to the physicians office
    Is this a new patient or an established patient?

    There is much debate on this
    Anyone know where I can find literature regarding this

    Thanks

  5. #5
    Default
    Quote Originally Posted by georgie14 View Post
    sorry to throw this in but if a physician sees the patient for an inpatient consult and does not see the patient in the hospital after the consult but then a week or two later the patient comes to the physicians office
    Is this a new patient or an established patient?

    There is much debate on this
    Anyone know where I can find literature regarding this

    Thanks

    The patient would be an established patient because the patient received professional services from that physician within the last 3 years.

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