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Ophthalmology and Optometry Coding Alert

Overcome Consultation Coding ConundrumsWith This FAQ

Published on Fri Mar 13, 2009

Caution: Avoid adding a consultation to every surgical procedure. When a primary care physician requests your ophthalmologists opinion, advice, and recommendations for treatment of a patient, consultation coding is a challenge even for veteran coders. The most important questions you must ask before ever assigning a consultation code are: " Does the encounter meet the definition of a consultation? " Is the intent clearly a request for recommendations on a treatment plan? You must also understand what constitutes a transfer of care or request for management of a patients condition. In the event the request meets the consultation definition and intent, know the six Rs to document a true consultation. Question 1:What are the required components for coding a consult? When you submit a claim for an appropriate consultation, you should be sure your providers documentation supports the consultation circumstances. Documentation requirements for consultations vary by payer, but experts say [...]
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