decisionhealth Newsletters, Part B News - 2006 Issue 1 (January)
CMS: No shared consults
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Article Overview
This short CMS-focused article summarizes guidance affecting consultation billing under Medicare. It is aimed at physicians, non-physician practitioners, and billing or compliance staff who need a general understanding of consult request communication and documentation expectations discussed in a CMS transmittal and related commentary.
Why This Topic Matters
Consultation claims can be denied or questioned if the service is treated incorrectly or if the request and report are not well documented. The article helps readers understand the broad compliance and recordkeeping issues addressed by CMS.
What You Will Learn
- How CMS characterizes consultation billing and the parties involved
- What general elements are associated with a consult request and response
- Why documentation of consult communications matters for compliance
- Which kinds of staff communication are discussed in relation to consult requests
Who Should Read This
- Physicians
- Non-physician practitioners
- Medical coders
- Billing staff
- Compliance staff
- Practice managers
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