Billing Inter-Practice Consultations

Why This Topic Matters

Inter-practice referrals can be billed differently from standard office visits, so understanding the scope of consultation reporting can affect compliance and reimbursement in ophthalmology.

Article Sections

1. Don’t be afraid to use consult codes inter-practice

   Introduces the topic of consultation billing within ophthalmology groups and why these encounters may be relevant to reimbursement. It frames the discussion around subspecialty referrals and billing considerations.

2. Typical inter-office consult scenario

   Describes the general setting in which a patient is referred from one eye-care clinician to another for a subspecialty opinion. It discusses the broad documentation and encounter components associated with this type of visit.

3. Established patients and continuing care

   Explains how the article addresses consultations for patients who have been seen before and how ongoing management within ophthalmology can affect the consult question. It also covers the role of the requesting physician in identifying a new subspecialty issue.

4. Medicare guidance and transfer of care

   Summarizes the payer guidance discussed in the article and how it relates to whether a consultation remains reportable when treatment is initiated. It also notes the importance of avoiding a full transfer of eye care.