tci Part B Insider - 2006 Issue 3

CONSULTS: Watch Out For 56 Modifier Trap With Pre-Op Consults

Document primary care consults the same as specialist onesIf you think consults are just for specialists, think again.Primary care physicians can provide consults too, say experts. A typical scenario is when a surgeon wants a family practice or internal medicine physician to make sure a patient's health problems are stable enough for the patient to withstand surgery. A patient may also seek out a primary care physician for a "second opinion" before surgery.Key idea: A primary care consult must be medically necessary and a physician or "other appropriate source" must request it unless the patient requested it...

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