Wiki Bill for both consults?

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bridgettemartin

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Our Gastroenterologist did a level 4 office consult for an enlarged liver and elevated LFT's. (The documentation supports a level 4 consult) During that visit, he determined the patient needed urgent, acute care and directed the patient to the ER for admission. The patient was admitted by the hospitalist. The next day, we were "consulted" for portal vein thrombosis and hepatic mass, and the ACNP did a level 4 in-patient consult (documentation also supports this). Her documentation states the patient was seen in our office the day before and was directed to the hospital for admission.
Can I bill for the hospital consult, or should it be a follow up? Is it POS driven? Meaning I can bill for both since one is POS 11, and the one the following day is POS 21. Or, is it dependent on the reason for the consult? In this case, the nurse practitioner states we didn't know about the portal vein thrombosis during the office visit.
Thanks!
 
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For years I worked for physicians who were mostly hospitalists but also did office work, and this situation would come up from time to time. I think you can code both consults - as long as the documentation supports both. I think a hospital consult is a different service from an office consult, and that it's fine to code both.
 
I disagree since the physician is the one that told the patient to present for admission, you cannot then be consulted back in to see the patient you referred for admission.
 
Thanks, Debra. I am willing to do some readjustment of my thinking on the consult issue.

Do you know of any documentation that might support your side on this? If my thinking has been wrong, I'll need to re-educate my physicians pronto!
 
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