tci Medicare Compliance & Reimbursement - 2009 Issue 5

CODING COACH:Consult or Referral? You Be The Judge

Know the 5 Rs to keep the auditors at bay and collect that extra $50 The feds have consult claims -- which pay about $50 more than an equivalent new patient visit -- under a microscope, so you'd better get your documentation straight today. To report a consultation code (99241-99255),Barbara Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC, has extended the 3 Rs into 5 Rs based on what Medicare has been looking for. They are: • Reason for consultation • Request for opinion • Render of opinion • Report back of findings: Your physician must provide a...

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