Ob-Gyn Coding Alert

Question: If our ob-gyn only reviews patient records but doesn't actually examine the non-Medicare patient, can we bill a consult?Oregon SubscriberAnswer: A consult is not a consult unless you meet the requirements. These requirements include: written request from a physician or other appropriate source medically necessary reason for the consultation face-to-face history, exam and medical decision-making rendered by the ob-gyn for the patient's problem written report sent to the requesting physician with recommendations regarding the patient's care.If your ob-gyn does not see the patient, you have no face-toface encounter to bill and therefore cannot report a consultation or any E/M service.If the ob-gyn sees the patient and simply does not perform an examination but the visit qualifies otherwise as a consultation , the physician would have to document face-to-face counseling and/or coordination-of-care activities that dominated the visit to be able to meet the criteria for reporting these codes in the [...]