Hello. I work for a pain management doctor and he sees what he thinks are a lot of consults. Most result in some type of management, or a subsequent procedure performed on a later date. My doctor thinks these should be billed as consults since the PTP is still participating in the patients care, he simply attempted to relive the patients pain, say with a standard ESI. I say these should be billed as a new patient appointment because he assuming the care of this specific issue and is providing an additional service other than his opinion. The frustrating part is the facility referring always marks both "referral" and "consult" then gets the patients insurance to authorize the consult code. He is using this as support for his argument that these visits are considered consults. Opinions please? Thanks!
Help! Consult or New Patient?
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