Billing pros: Don't make consult billing harder than necessary

Why This Topic Matters

Consult billing is a frequent source of denial and audit risk when documentation does not show the required request, service, and communication back to the requesting physician. Understanding the general framework helps practices report these services more consistently and avoid unnecessary complexity.

Article Sections

1. Consult billing basics and Medicare guidance

   Introduces the article’s focus on consultation billing under Medicare and points to the source guidance referenced by the author. It frames why consults are often reported incorrectly.

2. Documentation workflow and communication between physicians

   Describes the general communication pattern expected when a consult is requested, performed, and reported. It also discusses common confusion between consults and referrals.

3. When consultation reporting is no longer appropriate

   Covers the point at which the service is no longer treated as a consult and shifts to other evaluation and management reporting categories. It addresses patient-initiated second-opinion situations in broad terms.