Wiki To consult or not to consult?

[daboronda]

(Documented) Intent Matters for Consults, AAPC Cutting Edge, August 2013 is very clear on when to bill as a consult and when not too.

My question; we are a neurosurgical office that does not manage pain medications unless it is post-operatively.

If we see a patient in “consultation”, meet the requirements for request, reason and report, then refer the patient to physical therapy and order imaging and recommend pain medication, is this still a consult?
Thank you, Donna

 

[mhstrauss]

(Documented) Intent Matters for Consults, AAPC Cutting Edge, August 2013 is very clear on when to bill as a consult and when not too.

My question; we are a neurosurgical office that does not manage pain medications unless it is post-operatively.

If we see a patient in “consultation”, meet the requirements for request, reason and report, then refer the patient to physical therapy and order imaging and recommend pain medication, is this still a consult?
Thank you, Donna

Oh, how I love these gray areas. My opinion on this situation (and I do see this exact same thing often), is that if your NS is signing the order for PT, he is taking on treating the patient, and this is no longer a consult, but a Transer of Care. However, if he is only recommending PT, along with pain meds, and sending the patient back to the originating MD for that MD to order the PT and prescribe the meds, then yes, it is a consult. If your NS is not doing anything yet, until he sees the results of the imaging, then this still qualifies for a consult.

And of course, intent does matter also. The originating MD must also document clearly whether or not he intends for this to be a consult vs referral.

Just my 0.02...hope this helps!!