E/M: Consults versus visits. Key difference? A clear transfer of care, says HCFA

Why This Topic Matters

Correctly distinguishing consultation services from other E/M services affects claim selection, documentation expectations, and compliance with payer guidance. The article addresses a common area of confusion and highlights the importance of referral documentation and care transfer language in physician practices.

Article Sections

1. Consults versus visits

   Introduces the billing distinction being discussed and summarizes the central Medicare-era guidance topic. It frames the issue around evaluation and management services and physician relationships.

2. Clarification from HCFA

   Describes the agency clarification and the documentation themes raised in the article. The section focuses on how the guidance was being interpreted by clinicians and coding staff.

3. Provider reactions and documentation questions

   Shares reactions from specialty practices and the types of practical questions that remained after the clarification. It highlights how different offices viewed the updated guidance.