Question 2 way communication

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Homestead, Florida
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Does a letter to a referring source count for discussion of management or test interpretation with external physician/QHP or appropriate source?

I have a physician that feels "2 way communication makes me think though that if a doctor refers and sends a letter to us and then we send a letter back that it would count."

Any suggestions?
 

amyjph

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Munising, MI
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No, if you read the AMA definitions discussion requires an interactive exchange.
"Discussion: Discussion requires an interactive exchange. The exchange must be direct and not through intermediaries (eg, clinical staff or trainees). Sending chart notes or written exchanges that are within progress notes does not qualify as an interactive exchange. The discussion does not need to be on the date of the encounter, but it is counted only once and only when it is used in the decision making of the encounter. It may be asynchronous (ie, does not need to be in person), but it must be initiated and completed within a short time period (eg, within a day or two)."
 
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Does a letter to a referring source count for discussion of management or test interpretation with external physician/QHP or appropriate source?

I have a physician that feels "2 way communication makes me think though that if a doctor refers and sends a letter to us and then we send a letter back that it would count."

Any suggestions?
The only place I see referrals mentioned are for time-based coding.

It might also be helpful to show the doctor that "two-way communication" is not mentioned in the guidelines.
 

amyjph

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Munising, MI
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Yes, maybe you and the provider are talking about two different things?
When talking about telehealth or telemedicine the words "two-way communication" or "2-way communication" are often used.
If you are talking about billing a consultation code, those require report back to the referring provider. The 2021 office/outpatient guidelines don't apply to consultation codes.
And I agree as above, if you are billing a 2021 office/outpatient based on time, the activity of referring and communicating with other health care professionals (not separately reported) counts towards the time. it has to be on the same date of service.
 
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