Advanced Search

Radiology Coding Alert

Vocabulary Tip:

Don't Get Tangled in the 'Transfer of Care' Trap

Published on Wed Jun 22, 2005

Step up your efficiency with an understanding of this key term Because Medicare's consultation coding guidelines hinge on whether a referring provider requests an opinion or transfers care, you need to understand exactly what CMS considers a "transfer of care."

"A transfer of care occurs when the referring physician transfers the responsibility for the patient's complete care to the receiving physician at the time of referral, and the receiving physician documents approval of care in advance. The receiving physician would report a new or established patient visit depending on the situation (a new patient is one who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice, within the past three years) and setting (e.g., office or inpatient)." 

 - Section 30.6.10.B, Chapter 12, Medicare Claims Processing Manual.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Radiology Coding Alert

View All