# CPT codes requiring referring physician



## dyates (Apr 7, 2015)

I love a great challenge!  Anyone have information on where to obtain a COMPLETE listing of CPT codes that require a referring physician?  I have search high and low can't find any reference.  CMS doesn't have anything.

Thanks!

Diana


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## aclements (Apr 29, 2015)

Did you ever find the list? I am looking for the same list.

Thank you,
Angie 

Angela Clements, CPC, CEMC, COSC, CCS


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## j.monday7814 (Apr 29, 2015)

all consults require a referring physician based on the 3 R's. no other codes require a referring physician


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## danachock (Apr 30, 2015)

*Idea*

Hi, quick idea/brain storm - I know you are looking for information and I know the AAPC sends out a magazine every month with lots of great stuff. Just offering an idea; but maybe send them the request?? I see lots of people looking at your thread - I bet there are many coders out there that would benefit from this.
Thanks,
Dana


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## aclements (Jun 25, 2015)

It is more than just consults. I know radiology test, lab test, cardiology test, etc. need them. I was just hoping for a list without having to invent it myself. Medicare gives the claim denial ANSI codes for a claim missing this information and the broad list of services that have this requirement, I just can't find a specific list.

Thank you all for your responses!


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## AmandaBriggs (Jun 29, 2015)

I have a feeling that the term "referral" is being used instead of the proper term "order".  Any procedure or test will need a signed order by the requesting physician.  This includes, labs, radiology, surgical procedures, etc.  Even EKGs done in-house on cardiology patients need a valid, signed order or clear intent for the service to be done in the patient's chart.  Consults are the only thing that requires a true "referral" from a CPT standpoint as far as I am aware.


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## drsnpatil (Dec 15, 2017)

*Referring physician*

Hi Friends,

I am looking for list of CPT codes or supportive document regarding referring physician requirement on Part-B claims.


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