tci Medicare Compliance & Reimbursement - 2007 Issue 26

CONSULTS: Don't Cut The Requesting Doctor Out Of The Loop

Treatment, tests don't mean the visit's not a consult.Good news: One carrier issued a new "frequently asked questions" (FAQ) item on the confusing issue of consults. A provider asked Palmetto GBA a straight question, and Palmetto managed to give a straight answer. The question: Can a provider start additional testing or treatment at an initial consultation and still have the visit considered a consult?Palmetto's answer: Yes. A physician or qualified non-physician practitioner can start diagnostic services and treatment at the initial consult or a subsequent visit. But you shouldn't bill for "ongoing management" after the first consult...

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