Wiki New and consult visits

[gabbybella]

Hi all,

we have a situation with our ortho practice. We have locations which are walk-in 24 hour offices. Our doctors that pick up patients from there can they charge consult or new visits or do the need to be credentailed a certain way to be able to do that??

Thanks,

nikki

 

[CodingKing]

You can't bill a consult code for these unless it meets the definition of a consult. You have to meet the 3R's

http://healthleadersmedia.com/content/PHY-219949/Follow-three-Rs-when-coding-consultations

Whether or not you can see the patients depends on their insurance. The patient may find themselves with little or no reimbursement if their insurance doesn't cover providers who are not contracted and credentialed with the health plan. Some payers like Medicare do not accept consultation codes at all anymore.