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Urology Coding Alert

Reader Question:

Accept Consultations Referred by Many Sources

Published on Sat Oct 11, 2003

Question: Who can request a consultation from a urologist?

Kansas Subscriber Answer: Certainly a physician, a physician assistant, a nurse practitioner, a chiropractor, a podiatrist, an oral surgeon, and a clinical social worker can all request a consultation from a urologist. In fact, anyone who may receive payments from an insurance carrier for services that they provide can request a consultation.
 
A nurse who is not paid individually by an insurance carrier cannot request a consultation. However, a nurse in the emergency room triaging patients can call you to see a new patient. This is not considered a consultation, and you should report this service with a new patient E/M code.
 
Remember: If you don't have a request for your urologist's opinion or advice from a physician or other source, you cannot report a consultation code.
 
 - Answers to You Be the Coder and Reader Questions contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook, New York; and Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 19-urologist practice in Indianapolis.
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