decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Second Opinions / Overview
Subscribe or sign in to view the full article.
Article Overview
This overview discusses second and third opinions, patient-initiated visits, and related diagnostic services in the context of Medicare and CPT guidance. It is aimed at coders, billers, and clinicians who need a general understanding of how these encounters are framed for coverage and reporting purposes, especially when no physician referral is involved. The article also addresses the difference between patient-requested visits and consultation-type encounters at a high level.
Why This Topic Matters
Second-opinion encounters are common and can affect whether a visit is reported and covered as expected. Understanding the general Medicare and CPT framework helps reduce avoidable coding and billing mistakes for these services.
What You Will Learn
- How second-opinion and third-opinion encounters are discussed in a Medicare context
- How patient-initiated specialty visits are distinguished from consultation-type visits at a high level
- Why related diagnostic services may be part of the overall encounter
- What general considerations apply when prior testing already exists
Who Should Read This
- Medical coders
- Medical billers
- Physician practices
- Clinicians
- Revenue cycle staff
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com