Hello my fellow Coders,
I am posting this underneath two forums because it applies to both and I need as much feedback as I can get.
Yesterday I was thrown for a bit of a loop during a Medicare Webinar on consults that seemed to change what I have always been accustomed to. I am not new to coding however consults have been under quite a bit if scrutiny and I am trying to be as educated as possible so that I can educate my doctors as well.
Here is my scenario and question:
A patient presents to the ER with dysphagia. The ER doctor requests a GI consult. GI comes in and examines the patient (performs all the components of an E/M level). GI subsequently takes the patient to the endoscopy unit (or stays in the ER) and performs and EGD and removes a fish bone. The patient is discharged home with follow up instructions.
Question: Does GI bill a consult code? Why or why not?
PS: I know that a modifier would be needed on the E/M, and the procedural and dx coding my main focus is whether or not this is a true consult.
Thank You in advance for sharing your thoughts and opinions with me.
Kimm Hall CPC, CGCS, CMSCS
I am posting this underneath two forums because it applies to both and I need as much feedback as I can get.
Yesterday I was thrown for a bit of a loop during a Medicare Webinar on consults that seemed to change what I have always been accustomed to. I am not new to coding however consults have been under quite a bit if scrutiny and I am trying to be as educated as possible so that I can educate my doctors as well.
Here is my scenario and question:
A patient presents to the ER with dysphagia. The ER doctor requests a GI consult. GI comes in and examines the patient (performs all the components of an E/M level). GI subsequently takes the patient to the endoscopy unit (or stays in the ER) and performs and EGD and removes a fish bone. The patient is discharged home with follow up instructions.
Question: Does GI bill a consult code? Why or why not?
PS: I know that a modifier would be needed on the E/M, and the procedural and dx coding my main focus is whether or not this is a true consult.
Thank You in advance for sharing your thoughts and opinions with me.
Kimm Hall CPC, CGCS, CMSCS