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Pulmonology Coding Alert

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Don't Report a Consultation Code Unless You Have Proper Documentation

Published on Sun Apr 16, 2006

Use this form to save yourself time, effort and denials

Documentation--or lack thereof--can determine whether you'll see reimbursement for consultations that your pulmonologist provides. When another physician sends a patient to your office for a consultation, use the following document, provided by Patricia Trites, MPA, CHBC, CPC, CHCC, CHCO, CEO of Healthcare Compliance Resources in Augusta, Mich. You could either fax or mail the form, which provides a clearly documented request and reason for the consultation.

Bonus: For more information on recent clarifications on how you should report consultations, see the articles "Want to Report Same-Specialty Consultations? Experts Show You How" and "Add Another 'R' to Your Consultation Coding Checklist" in the April 2006 issue of Pulmonology Coding Alert. From the Healthcare Organization and Medical Office Compliance Program Guide
Copyright © 1999-2006. Used With Permission from Healthcare Compliance Resources LLC. Date Dear Dr. ______________, It is our understanding that you have requested Dr. ________________
to perform a consultation on your patient _______________________,
for the following condition, symptoms or problem: ______________________________________. We have appointed this patient on (date and time) _________________________________. Please forward any necessary medical records to our office that you believe are pertinent for the evaluation of this patient's condition. If our information is incorrect, please notify us as soon as possible so we may make the necessary changes. Dr. _________________________ will forward you his/her opinion regarding this patient as soon as possible following the appointment. Thank you,
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