Consult or Referral? So Much Depends on Documentation
Published on Thu Feb 19, 2009
Know the 5 Rs to keep the auditors at bay and collect that extra $50. The feds have consult claims, which pay about $50 more than an equivalent new patient visit, under a microscope, so you-ve got to get your documentation straight. To report a consultation code (99241-99255), Barbara Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC, has extended the 3 Rs into 5 Rs based on what Medicare has been looking for. They are: - Reason for consultation - Request for opinion - Render of opinion - Report back of findings: Your ENT must provide a written report back to the requesting physician that describes the consulting physician's findings, recommendations, etc. - Return: Discharge patient back to requesting physician. A Request Comes In When a doctor or NPP sends your ENT a patient, you have to determine what that provider is asking for. Does she want your ENT to [...]