Not sure I understand your question
I'm sorry, I'm not really understanding your question.
Sending a letter to the patient's primary doctor in and of itself does not constitute a consult. (Our surgeons send notes to all the PMCs just to keep them apprised of what's going on with their patients, but not ALL these visits are consults.)
If you are asking whether a letter to the requesting physician suffices as a "report" back ... well it should indicate the nature of the problem (including some history), the findings of the consulting physician (his exam and any diagnostic tests/labs/xrays) and the consultant's recommendations.
Your other office documentation would, of course, need to meet the requirements for documenting the level of consult (history, exam, MDM). But it would be fine for a cover letter to go to the requesting MD w/ a copy of the clinic note attached.
Hope I answered your question. If not, please clarify your dilemma.
F Tessa Bartels, CPC, CEMC