Wiki Inpatient consultations

[maine4me]

I had a question posed to me by our cardiologist group. They often see patient's in the hospital (med/surg) in consultation and they will often continue to see the patient and bill subsequent visits. The question is if the patient is them moved to rehab, (located in our facility, discharged from med/surg, new admission in rehab) can they bill a new consultation for the first visit in rehab. I am not sure that there is a new request for this consult, or if they are just following up based on the visits in med/surg. I feel that they have assumed care for the cardiac concerns and a new consult would be inappropriate. I advised them as such. One of the doctors said that another coder had advised them that since there was a change in place of service billing a consult is appropriate. I am not finding anything about this in the CPT book. Will someone please give me some guidance?

 

[mitchellde]

I had a question posed to me by our cardiologist group. They often see patient's in the hospital (med/surg) in consultation and they will often continue to see the patient and bill subsequent visits. The question is if the patient is them moved to rehab, (located in our facility, discharged from med/surg, new admission in rehab) can they bill a new consultation for the first visit in rehab. I am not sure that there is a new request for this consult, or if they are just following up based on the visits in med/surg. I feel that they have assumed care for the cardiac concerns and a new consult would be inappropriate. I advised them as such. One of the doctors said that another coder had advised them that since there was a change in place of service billing a consult is appropriate. I am not finding anything about this in the CPT book. Will someone please give me some guidance?

change of POS is not one of the components of a consult. You need the three Rs; Request, Render, Report.
Since they have already taken the patient for cardiology purposes there will be no need for the PCP or any other provider to Request a consultation from a cardiologist. The Request must be for reasons or issues unknown or unclear to the Requesting provider, and shows that he is asking for an opinion or input from the cardiologist. However since you have already undertaken management of the cardiology issues there will logically no longer be a need for this Request.