Question: In a recent discussion on the Orthopedic Coding Discussion list serve [accessed by going to www.medville.com/list/ then clicking on ortho], I believe the example regarding the wrist fracture not being a consultation is incorrect. The transfer of care relates to the total transfer of care, not for a specific problem. Review the Medicare carrier rule, 15506, on the HCFA Web site. The example is a consultation and fits all the criteria request, review and report. The patient will still return to his family doctor for routine care, not the orthopedic surgeon. This is no different from the patient sent to the general surgeon for a breast lump. The surgeon examines the patient, sends a report, biopsies the lump and sees her for follow up as needed. For routine medical care she still returns to the family physician, not the general surgeon. The first surgeon visit is a consultation.
