Wiki referring provider

[Cintia07]

Is there a criteria or list of CPT codes to change the referring provider for Novitas? Our Urologists see patients in the office and the referring by provider gets changed to themselves when a Medicare patient is seen. They do diagnostic tests like urinalysis, but not always. They also see patients at the hospital for consultations and the referring by is not changed. When is it appropriate to change the referring provider?

 

[jflynn124]

The referring should only apply to the E/M charge. Once the patient is seen by the specialist for diagnostic tests, x-rays in the office or procedures, then the rendering should be the only one on the claim.