Medical Billing Forum

Coding => Coding => Topic started by: Debbie G on April 05, 2013, 08:58:18 AM

Title: Consult vs New Patient
Post by: Debbie G on April 05, 2013, 08:58:18 AM
Would appreciate ya'lls opinion on this scenario:
PCP refers patient to Nephrologist for elevated BUN.  Nephrologist visits and exams patient and orders more labs and renal ultrasound.  Patient is to return in 2 weeks to discuss test results and plan.  This is a patient with commercial insurance.

Question--would you consider the initial visit a consult or new patient visit?  Nephrologist does not know until all test results are back if he will need to continue to see this patient.
Title: Re: Consult vs New Patient
Post by: DMK on April 05, 2013, 10:22:14 AM
If the patient was examined, and it meets e/m code guidelines, it's a new patient.  It's most likely a 99214 due to complexity.

A consult would be discussion only.