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- Jun 9, 2010
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Hello,
I am a fairly new attending, PM&R/Pain, in South Florida working as an independent contractor under a big group. I am now trying to establish inpatient pain consults to see patients under my own LLC group to supplement income. An experienced PM&R/Pain physician recently told me that if I see an inpatient consult patient for Pain Management on a day when a PM&R physician also sees the same patient on the same day, because I am PM&R/Pain (unlike Anesthesiology/Pain or “non-PM&R Pain), the payers would consider it as double billing as 2 PM&R doctors and I may not be paid. Is that true? It didn’t make sense because then an IM sub-specialist (ex. GI) shouldn’t be able to do an inpatient consult on a patient who has an IM hospitalist or if another IM sub-specialist (ex. Pulm) is seeing the same patient the same day.
Does this mean I as PM&R/Pain cannot do Pain consults at an inpatient rehab facility where PM&R doctors see patients as primary everyday??
I asked my billing company for clarification. After their research, they confirmed that if I happen to render Pain consult service on the same day when another PM&R sees the same patient - I should be okay as long as I:
(1) Document my note describing my care plan that clearly shows that it is for Pain (not PM&R)
(2) Categorize/Label my note properly under Pain Management (and not PM&R)
(3) Document that I am rendering my consult service specific to the Pain consult referral from the hospitalist
(4) Am not in the same group as the other PM&R doctor doing PM&R consult on the same patient
Do they sound correct?
***Also - what CPT codes do you use for Initial consult and Follow-Up consult?
As a rough guideline, I was recommended to use 99254 for Initial inpatient consultation and 99232 for Follow-Up inpatient consultation, but apparently the inpatient consultation codes may not be recognized for much longer? I also would like to ensure that I used the right codes for billing.
Thank you very much in advance!
I am a fairly new attending, PM&R/Pain, in South Florida working as an independent contractor under a big group. I am now trying to establish inpatient pain consults to see patients under my own LLC group to supplement income. An experienced PM&R/Pain physician recently told me that if I see an inpatient consult patient for Pain Management on a day when a PM&R physician also sees the same patient on the same day, because I am PM&R/Pain (unlike Anesthesiology/Pain or “non-PM&R Pain), the payers would consider it as double billing as 2 PM&R doctors and I may not be paid. Is that true? It didn’t make sense because then an IM sub-specialist (ex. GI) shouldn’t be able to do an inpatient consult on a patient who has an IM hospitalist or if another IM sub-specialist (ex. Pulm) is seeing the same patient the same day.
Does this mean I as PM&R/Pain cannot do Pain consults at an inpatient rehab facility where PM&R doctors see patients as primary everyday??
I asked my billing company for clarification. After their research, they confirmed that if I happen to render Pain consult service on the same day when another PM&R sees the same patient - I should be okay as long as I:
(1) Document my note describing my care plan that clearly shows that it is for Pain (not PM&R)
(2) Categorize/Label my note properly under Pain Management (and not PM&R)
(3) Document that I am rendering my consult service specific to the Pain consult referral from the hospitalist
(4) Am not in the same group as the other PM&R doctor doing PM&R consult on the same patient
Do they sound correct?
***Also - what CPT codes do you use for Initial consult and Follow-Up consult?
As a rough guideline, I was recommended to use 99254 for Initial inpatient consultation and 99232 for Follow-Up inpatient consultation, but apparently the inpatient consultation codes may not be recognized for much longer? I also would like to ensure that I used the right codes for billing.
Thank you very much in advance!
