Radiology Coding Alert

Step up your efficiency with an understanding of this key term

Because Medicare's consultation coding guidelines hinge on whether a referring provider requests an opinion or transfers care, you need to understand exactly what CMS considers a "transfer of care."

"A transfer of care occurs when the referring physician transfers the responsibility for the patient's complete care to the receiving physician at the time of referral, and the receiving physician documents approval of care in advance. The receiving physician would report a new or established patient visit depending on the situation (a new patient is one who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice, within the past three years) and setting (e.g., office or inpatient)." 

 - Section 30.6.10.B, Chapter 12, Medicare Claims Processing Manual.