Consult Requests

Gemini18

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NYMAC, GMAC
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Would "medical management and surgical clearance" -- be a valid reason for a consult. Also, where can I get a list of valid reasons for consults? My physicians will put any reason down for a consult and I know some of them are not valid.

Thank you.
 

RebeccaWoodward*

True Blue
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North Carolina
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Sugical clearance- Possible......

G. Consultation for Preoperative Clearance

Preoperative consultations are payable for new or established patients performed by any physician or qualified NPP at the request of a surgeon, as long as all of the requirements for performing and reporting the consultation codes are met and the service is medically necessary and not routine screening.

As for a list of reasons...the validity of the consult will be dependant on the intent for the visit. (The 3 R's)

30.6.10 is a good resource for this information. It also provides some examples of what does/doesn't constitute a consult

http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf
 

Gemini18

Expert
Messages
324
Location
NYMAC, GMAC
Best answers
0
Sugical clearance- Possible......

G. Consultation for Preoperative Clearance

Preoperative consultations are payable for new or established patients performed by any physician or qualified NPP at the request of a surgeon, as long as all of the requirements for performing and reporting the consultation codes are met and the service is medically necessary and not routine screening.

As for a list of reasons...the validity of the consult will be dependant on the intent for the visit. (The 3 R's)

30.6.10 is a good resource for this information. It also provides some examples of what does/doesn't constitute a consult

http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf

Thank you ;)
 
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