Wiki second opinion consult-can a doc

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It depends. Is the recieving consulting physician of a sub-specialty? Is the condition or issue above and beyond the requesting physicians scope or knowledge. (i.e. Urology physician who mainly manages prostate cancer asking a Urology physician [same specialty] who has extensive training in renal issues)
 
subspecialty consults/new patient/ or established patient?

Another part of this question is - Is there a way a coder can identify a subspeciality from the payor's view?

EXAMPLE: I have recently encountered a situation of a pt consult to a Nephrology clinic and the patient is currently also being treated by Urology. If both clniics are dealing with the "urological" system - it is possible that the payor would lump all services directed concerning this patient's urological system as part of a subspeciality and deny the service as a consult?
 
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