tci Part B Insider - 2006 Issue 4

CONSULTS: It Takes Two Physicians To Document A Consult Request

Doctors can request consults from others in the same groupYou may have spotless documentation for the consultations your physician performs, but you could still lose your consult reimbursement in an audit, thanks to some new rules. In Transmittal 788, dated Dec. 20, the Centers for Medicare & Medicaid Services says:• You have to have documentation of the consult request in both the consultant's records and the requesting physician's records. The request must be part of the requesting physician's plan of care for the patient, CMS says. • Non-physician practitioners can perform consults, but you can't bill for...

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