Advanced Search

Neurosurgery Coding Alert

Focus on Doc's Intent to Quickly Solve Consult, Referral Riddle

Published on Mon Apr 27, 2009

A letter of findings to the first physician doesnt always equal a consult. Choosing a consultation when documentation supports a referral could trigger refund requests. When a doctor or other health care professional with a National Provider Identification number sends your neurosurgeon a patient, you have to determine what that provider is asking for. "It all boils down to intent," says Rena Hall, CPC, billing/insurance specialist at Kansas City Neurosurgery Group LLC in Missouri. In other words, "does Dr. A want an opinion or suggestion for treatment options, or does he want Dr. B to treat the problem from that point on?" Think Consult When Opinion Is Sought If the requesting physician says to your neurosurgeon, "You have expertise in this area, and I need your opinion on how to proceed with this patient who has this chief complaint," and documents that reason in the patients chart, that meets the [...]
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.

Other Articles in this issue of

Neurosurgery Coding Alert

View All