When patient sent for diagnostic study, don't assume consult

Why This Topic Matters

Accurately identifying whether a referral is a consultation or simply a request for a diagnostic service affects E/M reporting, documentation needs, and claim accuracy. The article helps reduce the risk of billing errors when referrals are made for procedures or studies rather than for a physician opinion.

Article Sections

1. Referral scenarios in OB-GYN diagnostic services

   Introduces common referral patterns between primary care and OB-GYN practices involving diagnostic studies and procedures. It contrasts situations that may support a consultation with those that may not.

2. Documentation and referral intent

   Discusses the importance of documenting the referring physician’s request and clarifying whether the referral was for an opinion or for a specific diagnostic service. It also addresses how referral wording can affect interpretation of the visit.

3. Diagnostic procedures and care transfer

   Covers how diagnostic procedures may relate to E/M reporting and the concept of transfer of care. It also references documentation expectations from medical communication guidance.