Wiki Same MD billing in different specialities

[phillirk]

Physician treats patient in the endocrine subspecialty 2 years ago. Same physician has been requested for a consult for same patient but in the subspecialty of nephrology (so different diagnosis). Can the physician charge for a new patient consult for the nephrology visit?

I couldn?t locate any documentation stating it would be appropriate to bill as a new patient consult. My thought is the system will not differentiate between specialties when it?s the same doctor name and tax id.

 

[MarcusM]

Consult codes do not have new patient vs established patient. If you have a written referral from the treating and are not taking over the care, then you doctor should be able to bill a consult code if patient is not Medicare or a plan that follows Medicare rules on consults. Just be sure to follow consulting guidelines.