decisionhealth Newsletters, Part B News - 2006 Issue 7 (July)
When to bill a consult? Try existing guidance while CMS mulls issue
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Article Overview
This article discusses temporary guidance about when a consultation may be billed, based on a CMS-related policy discussion and input from coding and consulting professionals. It is relevant to physicians, nonphysician practitioners, coders, and billing staff who need to understand the general documentation and referral context surrounding consult claims while official clarification is pending.
Why This Topic Matters
Consultation billing remains an area of uncertainty, and this article highlights the broad documentation and referral themes practitioners are being advised to consider during the interim period.
What You Will Learn
- The general context behind CMS review of consultation billing guidance
- The types of referral and documentation elements discussed for consult considerations
- How the article frames interim decision-making around consultation versus other visit coding categories
- The role of practitioner communication and written reporting in the consult context
Who Should Read This
- Physicians
- Nonphysician practitioners
- Medical coders
- Billing staff
- Practice managers
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