Forum - Questions & Answers
Consults (non-Medicare) requirements
I'm going to ask a basic coding question, that I want to get some confirmation on...
For the non-Medicare world...can multiple consults be conducted by a physician, for the same patient, over separate hospital admissions? E.g. The admitting physician calls in a specialist, when the patient is admitted to the hospital...the patient has had several admits and discharges over the course of a year, and the specialist is called in to see the patient each time. Can the specialist charge a hospital consult each time he is called in by another physician?
Does anything change if this same patient is an established office patient?
Thanks.
You bet!!!!
Every time the doc is asked to see the patient, it is a consult in the hospital (only limit is once per admission) even if they are also seen in the office as an established patient.
multiple consults on a patient admitted multiple times
Yes, the inpatient consultations are not divided as new or established, and so can be billed on a patient in different admissions.
I always remind physicians: keep in mind the medical necessity of the level of consult. If this is your established patient, and you are asked to consult during an admission: what level of history and exam do you need? They don't all have to be high level.