Texascoder64
Guru
Is it ever appropriate to bill a consult code on a patient more than 1 time within a 3 year period ?
For example, the PCP sends a patient to us for a "rash", then patient returns at a later date for a full body skin exam. The provider stated that because we send a note back to the original referring Dr that should justify a consult code.
I feel that once the pt is established and we assumed care, then it become established for any future skin exams.
A payer has sent the provider an "educational" letter for repeat consultation codes on same patients, so I want to educate the providers on the appropriateness of billing office consultations.
Input from other specialist coders would be helpful.
Thank you
For example, the PCP sends a patient to us for a "rash", then patient returns at a later date for a full body skin exam. The provider stated that because we send a note back to the original referring Dr that should justify a consult code.
I feel that once the pt is established and we assumed care, then it become established for any future skin exams.
A payer has sent the provider an "educational" letter for repeat consultation codes on same patients, so I want to educate the providers on the appropriateness of billing office consultations.
Input from other specialist coders would be helpful.
Thank you