ER Consult

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Question:

What if the ER physician sends a patient to me, say for a horrible rash, for evaluation. I see the patient, evaluate the rash, treat it, and send the ER physician a letter. Is this a consult? I’ve been billing these as new patients, but the encounter certainly meets the criteria for a consult.

Answer:

These are not consults (9924x) from a CPT perspective – these are new patients (9920x) so you’ve been doing it right! There is no mandate to send the ER doctor a letter. This is a transfer of care because the ER doctor is not going to use your information for ongoing coordination of care for that patient (the ER doctor hopes never to see that patient again!). This is basically a self-referred patient (9920x).