General Surgery Coding Alert

Reader Questions:

Bill Consultations With a Referral

Question: When another doctor refers a patient to our surgeon, who meets with the patient in the office before going on to perform surgery at a later date, is this a new patient visit or a consultation? Our surgeon always sends a report to the referring physician. Sometimes the other doctor sends a written referral, but sometimes we just get a phone call or the patient states that her doctor referred her -- does that impact the coding?Answer: You can bill the situation you've described as a consultation (99241-99245, Office consultation for a new or established patient ...) under the 2010 consultation guidelines.A consultation is a request for opinion, advice, or guidance, and your surgeon is always providing that service when he must examine a patient prior to deciding whether to become involved in the patient's care.That's not all: Make sure you meet all of these requirements before you bill a [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.