Urology Coding Alert

Question: A patient is referred by his primary-care physician to Dr. A, a urologist. The patient goes home, thinks about it, and decides instead to go see Dr. B, a urologist the patient saw six years ago. Dr. B. sees the patient and sends a report to the referring primary-care physician. Can Dr. B. bill a consult?

Anonymous Pennsylvania Subscriber

Answer: The only kind of consult Dr. B. can bill is a confirmatory consultation (99271-99275) because the patient has decided to go to Dr. B. on his own for treatment. Instead of going to Dr. A so Dr. A can give his or her opinion to the primary-care physician, the patient is going to Dr. B on the patient's own recommendation, not on the referral of the primary-care physician.