Advanced Search

Urology Coding Alert

Reader Question:

Consultations

Published on Wed Mar 01, 2000

Question: A patient is referred by his primary-care physician to Dr. A, a urologist. The patient goes home, thinks about it, and decides instead to go see Dr. B, a urologist the patient saw six years ago. Dr. B. sees the patient and sends a report to the referring primary-care physician. Can Dr. B. bill a consult?

Anonymous Pennsylvania Subscriber

Answer: The only kind of consult Dr. B. can bill is a confirmatory consultation (99271-99275) because the patient has decided to go to Dr. B. on his own for treatment. Instead of going to Dr. A so Dr. A can give his or her opinion to the primary-care physician, the patient is going to Dr. B on the patient's own recommendation, not on the referral of the primary-care physician.
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

Urology Coding Alert

View All