referrals

  1. S

    Wiki What element level of MDM would a specialist referral fall under 2021 E/M Guidelines?

    Our PCP providers would like to consider a referral to a specialist as a LOW RISK under column 3 of the 2021 E/M table for Risk of Complications and/or Morbidity or Mortality of Patient Management. In comparison to Box A. of the 2020 & earlier E/M table and guidelines, whether a condition was...
    • SLindloff
    • Thread
    • 2021 e/m 2021 e/m risk 2021 guidelines e/m changes mdm risk medical decision making referral referrals
    • Replies: 8
    • Forum: E/M
  2. D

    Wiki Referral Carolina Access - Medicaid NC

    I know standard Medicaid does not require a referral and I understand that Carolina Access does for a specialist. My question is does the referral have to have an authorization number on it? I thought it did and when I called the PCP and asked for one I could feel them stare at me through the...
  3. K

    Wiki Medicare: Telephone Visit Guidelines & Referrals

    I believe I have a comfortable grasp on what can be coded during the COVID-19 changes for my FQHCs but I'm running into a semantics issue and would love some input. Normally there would be a medical service for multiple conditions and some of those may be referred to other specialists. A common...
  4. B

    Wiki Referral Gifts

    Hello my fellow AAPC Compliance Officers, I had a question about whether it is legal for a Medical Billing company to offer a thank you gift to physicians who refer them to other medical practices. This is based on high level of satisfaction of their service and not that the billing company...
  5. S

    Wiki Medical nutrition therapy

    Hello All~ Can someone please direct me to where I can find a policy or information on billability requirements for MNT for a NON-MEDICARE patient who is SELF-REFERRED? I see a lot on Medicare requirements and that we are unable to bill for MNT services WITHOUT a Provider referral and covered...
  6. D

    Wiki Referrals and MDM - I work for an urgent care

    Good Afternoon, I work for an urgent care organization and we average roughly 60 referrals per day. I reviewed the CMS 2014 E&M guidelines and under the MDM section for "Number of Diagnoses and/or Management Options": If referrals are made, consultations requested, or advice sought, the...
    • danadove
    • Thread
    • calculated day mdm referrals services
    • Replies: 2
    • Forum: E/M
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