In Office Consultation vs New Patient

There seems to be some controversy in our office in regard to proper billing of consults in office.

Does a insurance referral enough to bill as a consultation?

Is something in writing other than a insurance referral needed as well to bill a consultation visit ?

Thank you
Darlene

re: In Office Consultation vs New Patient

it must be stated in the office note that the patient is being seen at the request of another physician (our dr's even dictate the name of the referring). the note must also be CC'd to that physician in order to bill a consult.

referral is not enough.

re: In Office Consultation vs New Patient

We do include the referring Doc's name in the documentation and letter is sent to the referring Doc.
I think we need the referring Doc's last office note or something from the referring Dr's office stating they are consulting to us. Do I ?

Thanks
Darlene

re: In Office Consultation vs New Patient

there are also many insurances that do not accept consults. CMS no longer accepts them as of 1/1/2010. any insurance that goes by CMS guidelines will be the same. all of your Medicare advantage programs, Tricare, Medicaid, etc.