Wiki Subspecialty Consult

[bridgettemartin]

I posted this in the Behavioral Health Forum and got no hits, so I'm trying here to see if anyone has any input.

I am coding the pro-fees for in-patient mental health stays. I have a subspecialty consult question.

Pt is being following by Psychiatrist A for their in-patient stay. Their dx is 296.34. Psychiatrist A states pt's Major Depressive Disorder is treatment resistant and thinks ECT(90870), may be helpful. Psychiatrist A does not do ECT so he asks Psychiatrist B (in same Practice as Psychiatrist A) to see the patient.
Psychiatrist B sees the patient, reviews all mental health and medical records (including CT scans, labs, EKG) and determines ECT should be the next step. During that consult, he also goes over the risks and benefits of ECT. He spends 60 minutes with the patient doing this assessment.
Can Psychiatrist B bill for his consult services? The patient started the ECT series the following day.
Both Psychiatrists saw the patient the same day.
And, does anyone know of any resources on this matter?
Thanks!

 

[ccollison]

Unless provider B is a different specialty or subspecialty, and is listed with the insurance credentialing dept as a different specialty, usually same services provided by the same group for the same d/s are not payable. I have had the same scenario happen with only denials.
CCollison CPPM, CCC

 

[cfullum]

They are of the same subspecialty, therefore you can only give credit to one physician and it should be the physician that saw him first.