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Billing and Financial

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Post Consult Codes
Author: ALD23
Date: Apr 11, 2008 10:46 am
I am starting a new pall care practice. Several have told me I can bill as a consultant if referred by a IM/FP physician if we use different diagnosis codes. Others have indicated that has not yet been approved by medicare despite our specialty status and will not withstand an audit. I do not want to commit fraud--can anyone advise?
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Re:Consult Codes (by kkerr on 05/05/2008)
Hello, Great question. Yes - that is how consultant billing works - the pallative care consulting MD bills off the diagnsois code that is appropriate to the symptom or issue that generated the consutaltion request, and this is different than the code that the primary physician would use. The PC consultant bills on "pain" and the primary physician bills on "colon cancer", for example. There is an excellent overview of physician billing available at: http://www.capc.org/support-from-capc/capc_presentations/index_last_html/view?searchterm=physician%20billing and some billing tools that might be useful are available at: http://www.capc.org/tools-for-palliative-care-programs/billing-tools Regards, Kathleen Kerr Senior Analyst University of California San Francisco (UCSF) Palliative Care Leadership Center

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