Re: ferral vs consultation
From: art fougner, md (evsono@pipeline.com)
Sat May 10 14:26:51 2008
Just another example how CPT Codes have enhanced patient care.
/sarcasm
Art
At Sat, 10 May 2008, RModugno@aol.com wrote:
>
>>From ACOG:
>
>If a primary care doctor sends a patient to me because of a bartholins gland
>cyst and I see the patient, place a words catheter, and manage the patient,
>can I charge the initial visit as a consultation with other visits as
>established?
>
>Or is this simply a referral and should it be charged as a new patient only
>since I am not just rendering an opinion, but have actually assumed care of
>the patient for a particular issue?
>
> Topic: Conf: _CPT/ICD9 Coding and Reimbursement_
>(http://www.acog.org:8080/confinfo?4) From: _Savonne Montue_
>(http://www.acog.org:8080/userpeek?49258) (_smontue@acog.org_ (mailto:smontue@acog.org) ) Date:
>Wednesday, April 25, 2007 10:26 AM
>The following should assist you with deciding how to code your case.
>
>Transfer of Care/Referral:
>When a physician refers the patient to a specialist to manage a portion or
>all of a patient’s condition – that is a transfer of care. The physician will
>no longer be treating that patient’s condition for which the patient is
>seeing the specialist. This transfer of care indicates to you that the referral
>to the specialist is a visit, not a consultation.
>
>Consultation:
>When a physician requests an opinion or advice from another physician
>regarding the evaluation and/or management of a specific problem for a patient, it
>is a consultation. The consulting physician may initiate diagnostic and/or
>therapeutic services during this visit. Both the request and need for the
>consultation should be documented in the patient’s medical record. The consulting
>physician must prepare a written report which describes his or her findings
>and any services ordered or performed. This report must be sent to the
>requesting health care provider.
>
>Subsequent Visit:
>If the consultant either initiates the second visit or is providing ongoing
>management of the patient’s problem, then he or she reports an established
>patient E/M code not a consultation code.
>
>Savonne Montue, RHIT, ACS-OB
>Coding Specialist
>The American College of Obstetricians &
>Gynecologists (ACOG)
>Email: Coding@acog.org
>Fax: 202-484-7480
>
>******************************************************
>Robert Modugno MD MBA FACOG=20
>Sylva, NC
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
