Coding > Coding

Consult vs New Patient

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Debbie G:
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.

DMK:
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. 

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