Wiki consult with return visit

[lizardw5]

Hello fellow coders,
if you have a consult and the documentation states the patient will return visit in one week, would you still bill a consult? I was taught that it would be inappropriate, because it is known and documented at the time of the visit that the patient is returning, so consultation code is incorrect, as the physician is assuming care (ie; the return visit).
I reviewed recent Cutting Edge articles and it seems the intent is clear and consult is not the right code.
I appreciate any information.
Sincerely,
Elizabeth

 

[mhstrauss]

Hello fellow coders,
if you have a consult and the documentation states the patient will return visit in one week, would you still bill a consult? I was taught that it would be inappropriate, because it is known and documented at the time of the visit that the patient is returning, so consultation code is incorrect, as the physician is assuming care (ie; the return visit).
I reviewed recent Cutting Edge articles and it seems the intent is clear and consult is not the right code.
I appreciate any information.
Sincerely,
Elizabeth

I mostly agree with what you have stated above. The only other thing that might make a difference (I remember reading this somewhere before, but not sure where), is that if the doc orders any diagnostic tests at the initial visit, and needs to see the results of the test before he can determine whether or not he will take on the patient's care, then he is still allowed to bill a consult for the initial visit. So if the follow-up a week later is to go over bloodwork, x-rays, etc, then I do agree with the consult. But if he initiated any treatment whatsoever at that first visit, it is no longer a consult; it turns into the "assuming care" scenario.

Hope this helps!