Wiki Who can refer a patient for a consult?

[michelledeaton@yahoo.com]

I am looking at a claim which our physician conducted a consult. The referring "dr" is a PA. My claim is not clearing my claim edits due to an NPI being necessary for the consult. Can I bill a consult with a PA being listed as the referring?

 

[MnTwins29]

Yes. In the CPT notes under consultations, it states that the service is provided "at the request of another physician or appropriate source..." Further down, this "appropriate source" is defined as "e.g. Physician assistant, nurse practitioner, doctor of chiropratic..." There are more listed, but to answer your question, yes, a PA can make the request for a consultation.

 

[michelledeaton@yahoo.com]

PA and consults.

I did see that. Thank you for confirming.

Can you tell me should I use the main doctor's NPI? Would this be appropriate?

 

[MnTwins29]

I would use the PA's NPI

 

[michelledeaton@yahoo.com]

Pa npi

I was informed by our office manager that a PA does not have an NPI.

 

[mhstrauss]

I was informed by our office manager that a PA does not have an NPI.

All of our PA's (and NP's, PT's, OT's) have their own NPI's. Does the PA bill out any services? If yes, (s)he should have their own NPI. You can search on this website:

https://npiregistry.cms.hhs.gov/NPPESRegistry/NPIRegistrySearch.do?subAction=reset&searchType=ind

 

[MarcusM]

Remember to send a report to the referring source to complete the consultation requirements.