Wiki Coding

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I would say it would first depend on whether or not the payer even accepts consultation codes. Many payers followed CMS's lead and have directed providers to submit either outpatient or inpatient E/M codes instead.
 
From AHIMA http://library.ahima.org/doc?oid=67356#.XsQXAW5FxqM :
In order for a service to be considered a consultation, the following criteria must be met and documented:
  • A request for a consultation, along with the need for a consultation, must be documented by the consultant in the patient's medical record and included in the patient's medical record of the requesting practitioner.
  • An opinion is rendered by the consulting practitioner. This opinion, along with any other service provided, is documented in the patient's health record.
  • A written report of the consultant's findings and opinion or recommendation is communicated back to the requesting practitioner.
And as pointed out by Amanda above, many carriers no longer accept consultation codes.
 
csperoni said:
From AHIMA http://library.ahima.org/doc?oid=67356#.XsQXAW5FxqM :
In order for a service to be considered a consultation, the following criteria must be met and documented:
  • A request for a consultation, along with the need for a consultation, must be documented by the consultant in the patient's medical record and included in the patient's medical record of the requesting practitioner.
  • An opinion is rendered by the consulting practitioner. This opinion, along with any other service provided, is documented in the patient's health record.
  • A written report of the consultant's findings and opinion or recommendation is communicated back to the requesting practitioner.
And as pointed out by Amanda above, many carriers no longer accept consultation codes.
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THANK YOU!!!!
 
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