valerief07
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We all know that you can no longer bill Medicare/Medicaid for consultations but there are still carriers that will pay for these. We have a disagreement in our office about charging consultations. Anyone that could help clarify this.
I am not sure if our problem is with the actual referral to us or when the assumption of care starts.
Example:
Patient referred to us from primary care referral states "Referred for Lt Knee bucket handle tear of entire Medial meniscus" My physician see and evaluates this patient and decides to schedule him for surgery. He wants to charge a consult.
Question:
Can he charge consult? My thinking is that he agreed to assume the care when the referral was sent with a diagnosis already on it. The PCP was sending patent because he wanted us to handle the case. Not give him an opinion an send patient back. My physician wants to disagree and states that he needed to do the consult before he could make decision to go to surgery.
AAOS states that a physician can order test and schedule surgery and still bill a consult.
CPT states that if physician assumes part or total care of the patient it is no longer a consult.
Can anyone help the confusion in our office???????
I am not sure if our problem is with the actual referral to us or when the assumption of care starts.
Example:
Patient referred to us from primary care referral states "Referred for Lt Knee bucket handle tear of entire Medial meniscus" My physician see and evaluates this patient and decides to schedule him for surgery. He wants to charge a consult.
Question:
Can he charge consult? My thinking is that he agreed to assume the care when the referral was sent with a diagnosis already on it. The PCP was sending patent because he wanted us to handle the case. Not give him an opinion an send patient back. My physician wants to disagree and states that he needed to do the consult before he could make decision to go to surgery.
AAOS states that a physician can order test and schedule surgery and still bill a consult.
CPT states that if physician assumes part or total care of the patient it is no longer a consult.
Can anyone help the confusion in our office???????