tci Medicare Compliance & Reimbursement - 2006 Issue 33

PHYSICIANS: Want To Be Free Of Consult Confusion? Here's Some Good News

It's not a consult if the requesting physician 'doesn't give a rip.'Your cries for clarification of what constitutes a consult may have been answered.Some physicians have worried that nothing would count as a consult any longer, ever since the Centers for Medicare & Medicaid Services (CMS) issued Transmittal 788 last December. The transmittal clarified various consult questions, but also included a new definition of "transfer of care" that would make it much harder to bill for a consult.The new definition reads: "A transfer of care occurs when a physician or qualified NPP requests that another physician...

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