# inpt consults - when doctors say "I will follow along with the patient"



## eagomar (Feb 22, 2010)

Hello,

I have a question regarding the wording at the end of inpatient consults.

We have several instances where a hospitalist will request a consult from a pulmonologist. I sometimes find at the end of the report, where the doctor will say "thank you - I will continue to follow along with you" or "I will continue to follow the patient". Does this wording negate the consult and become subsequent care??? 

Our doctors are saying that it doesn't make sense that this is the first time they are seeing the patient and this should be considered a consult regardless if they say they will continue to follow. I always believed that as soon as they say those words, they are assuming care and 9 times out of 10 bill a subesequent visit the next day anyway. 

Please clarify - Thank you!


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## Lisa Bledsoe (Feb 22, 2010)

Based on the revised text in CPT for consultation codes allowing the "consultant" to determine whether or not to accept responsibility for ongoing management of a specific condition; I would still count it as a consult, coding it of course as an initial visit IF all requirements are met.


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## eagomar (Feb 22, 2010)

Thanks lisa

I guess I always thought that when they say those words, then there is a transfer of care. Since I can't find any specific articles about wording in a consult, then as you said it is up to the consultant to determine whether or not they are accepting responsibility


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## Lisa Bledsoe (Feb 22, 2010)

It used to be at the intent of the requesting physician, but with CMS now not recognizing consult codes and the AMA revising the text it leaves the door a little more wide open.  At least this is how I view it.


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## valleycoder (Feb 24, 2010)

i agree with lisa. if its not a medicare patient and it meets all other requirements (request, etc), i would bill as a consult.


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