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Orthopedic Coding Alert

Did Your Ortho Do a Consult or Referral? You Be the Judge

Published on Sun May 03, 2009

Collect that extra $50 by applying the 5 Rs. Beware: The feds are shining their spotlight on consult claims. Can your documentation withstand scrutiny? Compare your consult versus referral coding practices to our experts advice to keep auditors at bay. Remember: To report a consultation code (99241-99255), you should extend the 3 Rs into 5 Rs, says Barbara Cobuzzi, MBA, CPC, CENTC, CPC-H, CPCP, CPC-I, CHCC, president of CRN Healthcare Solutions in Tinton Falls, N.J. They are: 1 Reason for consultation 2 Request for opinion 3 Render an opinion 4 Report back of findings: Your physician must provide a written report back to the requesting physician that describes the consulting physicians findings,recommendations, etc. 5 Return: Discharge patient back to requesting physician. What to Do When a Request Comes In When a doctor or NPP sends your orthopod a patient,you have to determine what the outside provider is asking for. Does [...]
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