Wiki established pt. - consult

[shelly1966]

I work in an Oncology clinic and our Dr. has been seeing a pt. for Multiple Myeloma which is now in remission. His last follow-up on that problem was in Jan. of 16.
He has done a Consult (99205), Jan. 2016 on the same pt. for another Dr. for a different dx. (prostate cancer).
Can you charge and code for a consult, before the 3 yr. time frame, if it is a different diagnosis?
thanks!!!

 

[mitchellde]

You cannot charge a new patient encounter for an established patient. If the payer is Medicare or a payer that follows Medicare policy for consults, you must use established patient codes.

 

[shelly1966]

Thank you!!!!