tci General Surgery Coding Alert - 2017 Issue 7

E/M: Master the Rules for Consultation and Referral Billing

Remember different Medicare rules. If you don’t know the difference between consults and referrals and what that means for your E/M code selection, you could be cruising toward missing payment opportunities — or facing fraud charges. Read on to learn documentation tips, coverage issues, and payment differences for your consultation and referral surgical cases. Learn This Ironclad Referral Rule “Referral normally implies that all or a portion of the patient’s care will be transferred to a new provider,” says Laureen Jandroep, CPC, COC, CPC-I, CPPM, founder/CEO Certification Coaching Organization, LLC in Oceanville, N.J. Note...

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