Wiki Problem has been established with PCP

[DIVINE50]

If a hearing problem has already been established with the PCP by them performing a screening hearing test and they are referring onto the ENT doctor for a hearing test can the ENT charge for a office visit?

There is an onsite Audiologist at the ENT office so I am wondering if the patient should be scheduled directly with them since the hearing problem has already been established.

Any thoughts or articles I can refer too?

 

[cjhalk@yahoo.com]

It sounds like the patient is going to see two separate providers in two separate clinics.
I would absolutely say yes, the audiologist can charge an office visit plus anything else they can medically justify.
A provider has never been expected to work off of another provider?s exam or history or medical decision making when a referral is put. They are allowed to do their own history and exam. Something else to think about; The PCP probably did a history and exam that covered other elements. The audiologist would do an exam and history in my guess would be more focused on the ears.
But yes, I do think if the providers are not connected to each other ? then yes, I think the audiologist can charge an office visit.

 

[DIVINE50]

I was asking if the ENT can charge for a new patient E/M if the pcp has already established that the patient needs a hearing test. Not the audiologist. They are seeing the ENT first but the problem was already identified by the PCP so I didn't know if the ENT could charge an E/M code and then send the patient onto the audiologist for the hearing test. Can someone help with this asnswer?

 

[mhstrauss]

I was asking if the ENT can charge for a new patient E/M if the pcp has already established that the patient needs a hearing test. Not the audiologist. They are seeing the ENT first but the problem was already identified by the PCP so I didn't know if the ENT could charge an E/M code and then send the patient onto the audiologist for the hearing test. Can someone help with this asnswer?

The ENT can charge a new patient visit, since the ENT and the PCP are of different specialties. However, the medical necessity needs to be there also. If the PCP has already determined that the patient needs a hearing test, why is it necessary for the ENT to see the patient also? But if the PCP noted that (s)he is referring the patient to the ENT for evaluation for possible hearing test, that would be completely different. Just depends on how the PCP documented.

Hope that helps!