Question: After billing 92422/132 for an initial consult, can a dr bill 91824/110 for a review appointment (first review/fup appt after the initial consultation).
Answer:
Both items,132 and 110, are designed as initial consultations in a single course of treatment. That mutually excludes them as a follow-up.
That is unless a practitioner decides that another course of treatment needs to be established. e.g. A patient was treated with medication A for condition X, and now this patient needs to be treated with medication B for condition Z. That scenario is likely if you go fully multidisciplinary and use an enhanced communication model with the GPs.
110
Group
A4 – Consultant Physician Attendances To Which No Other Item Applies
Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) following referral of the patient to the consultant physician by a referring practitioner-initial attendance in a single course of treatment
132
Group
A4 – Consultant Physician Attendances To Which No Other Item Applies
Professional attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 45 minutes in duration for an initial assessment of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) following referral of the patient to the consultant physician by a referring practitioner, if:
(a) an assessment is undertaken that covers:
(i) a comprehensive history, including psychosocial history and medication review; and
(ii) comprehensive multi or detailed single organ system assessment; and
(iii) the formulation of differential diagnoses; and
(b) a consultant physician treatment and management plan of significant complexity is prepared and provided to the referring practitioner, which involves:
(i) an opinion on diagnosis and risk assessment; and
(ii) treatment options and decisions; and
(iii) medication recommendations; and
(c) an attendance on the patient to which item 110, 116 or 119 applies did not take place on the same day by the same consultant physician; and
(d) this item has not applied to an attendance on the patient in the preceding 12 months by the same consultant physician