decisionhealth Newsletters, Answer Books - 2009 Issue 9 (September)
Consults, Visits, Referrals / Follow-up care
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Article Overview
This article explains broad follow-up care and consultation guidance in the hospital, office, and outpatient settings, with attention to Medicare policy references and changes affecting consultation-related reporting. It is relevant for coders, billers, and compliance staff who need to understand how consult-related services and subsequent visits are discussed at a general level without relying on the full premium text.
Why This Topic Matters
Consultation and follow-up visit reporting can affect claim selection, compliance review, and internal billing policies. The article also highlights Medicare policy references and deleted consultation code families that may influence how organizations review older or legacy processes.
Article Sections
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Follow-Up Consultations
Discusses follow-up consultation guidance across inpatient and outpatient settings and references Medicare policy material relevant to subsequent visits.
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Consultation Requests by Members of Same Group
Covers consultations requested within a group practice and the general policy context for those requests.
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Second Opinion E/M Service Requests
Addresses second-opinion evaluation and management services, including Medicare-related discussion and follow-up visit context.
What You Will Learn
- How the article frames follow-up consultation topics in different care settings.
- What general Medicare policy areas are referenced in relation to group-practice consultation requests.
- How the article presents second-opinion evaluation and management services and related follow-up care topics.
Who Should Read This
- Medical coders
- Medical billing staff
- Compliance professionals
- Practice managers
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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