Part B Insider - 2010 Issue 11
Reader Questions: Bill Consultations With a Referral
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Article Overview
This reader Q&A explains the general billing scenario of a referred patient being evaluated before a later procedure, with emphasis on whether the encounter is treated as a consultation or a new patient visit. It summarizes the documentation and referral-source considerations described in the CPT consultation guidance, along with the impact of a recent change in written-request requirements. The article is relevant to surgeons, office-based coders, billers, and revenue cycle staff who handle evaluation and management reporting.
Why This Topic Matters
Correctly identifying the visit type affects evaluation and management reporting and documentation requirements. The article also addresses how changes in consultation rules can affect billing workflows for referred patients.
What You Will Learn
- How referral-based office visits are discussed under consultation reporting guidance
- What general documentation elements are associated with consultation billing
- How the article describes the effect of a change in written referral requirements
- When the article says a new patient visit may be considered instead of a consultation
Who Should Read This
- Medical coders
- Billers
- Surgeons
- Office staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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