Wiki New consult

[jokirby]

Just to clarify, I have a physician who is new to the specialty practice who is to see a patient who is new to him but not to the clinic. He wants to use a consult code which is fine if the patient is referred from outside our clinic correct? The visit will be documented and sent out to the referring physician.

 

[FTessaBartels]

Consult vs Established

If another physician is requesting your specialist's advice/opinion on the management of the patient's problem, then it is a consult. Even if the patient has been previously seen in your clinic for the same or similar problem.

If the patient is being referred for care of a problem, then it is a new or established patient depending on whether this patient has seen anyone of the same specialty and same practice in your clinic in the last 3 years. So if John Doe has a painful knee and saw Ortho Doc A in May for this problem, and now is coming in with the same painful knee and will see New Ortho Doc B ... John Doe is an EXISTING patient. (Even if New Ortho Doc has never seen the patient himself.)

Hope that helps.

F Tessa Bartels, CPC, CEMC