Medicare Compliance & Reimbursement

Know the 5 Rs to keep the auditors at bay and collect that extra $50 The feds have consult claims -- which pay about $50 more than an equivalent new patient visit -- under a microscope, so you'd better get your documentation straight today. To report a consultation code (99241-99255), Barbara Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC, has extended the 3 Rs into 5 Rs based on what Medicare has been looking for. They are: • Reason for consultation • Request for opinion • Render of opinion • Report back of findings: Your physician must provide a written report back to the requesting physician that describes the consulting physician's findings, recommendations, etc. • Return: Discharge the patient back to the requesting physician. A Request Comes In When a doctor or NPP sends your doctor a patient, you have to determine what that provider is asking for.Does she want your physician [...]