ED Coding & Reimbursement Alert - 2007 Issue 9
Consult Confusion Will Continue Into Next Year
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Article Overview
This article discusses unresolved confusion around consult billing and transfer-of-care interpretation in the context of CPT and CMS guidance. It covers why clarification was delayed, how CMS and related oversight bodies are involved, and why the issue matters for physicians, specialists, and billing/audit staff. The piece is relevant for readers following Medicare policy, physician fee schedule updates, and compliance risk related to consult claims.
Why This Topic Matters
The article helps readers understand that the consult issue remained unsettled, which could affect documentation review, compliance preparation, and audit exposure for providers billing physician consultation services.
What You Will Learn
- Why the consult-versus-transfer-of-care issue remained unresolved
- How CMS and CPT-related policy activity affected the timing of clarification
- Why the issue was viewed as relevant to audits and compliance review
- What broad communication/documentation considerations were highlighted for physicians and specialists
Who Should Read This
- Physicians
- Specialists
- Practice managers
- Medical coders
- Billing staff
- Compliance professionals
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