Wiki CPT codes requiring referring physician

[dyates]

I love a great challenge! Anyone have information on where to obtain a COMPLETE listing of CPT codes that require a referring physician? I have search high and low can't find any reference. CMS doesn't have anything.

Thanks!

Diana

 

[aclements]

Did you ever find the list? I am looking for the same list.

Thank you,
Angie

Angela Clements, CPC, CEMC, COSC, CCS

 

[j.monday7814]

all consults require a referring physician based on the 3 R's. no other codes require a referring physician

 

[danachock]

Idea

Hi, quick idea/brain storm - I know you are looking for information and I know the AAPC sends out a magazine every month with lots of great stuff. Just offering an idea; but maybe send them the request?? I see lots of people looking at your thread - I bet there are many coders out there that would benefit from this.
Thanks,
Dana

 

[aclements]

It is more than just consults. I know radiology test, lab test, cardiology test, etc. need them. I was just hoping for a list without having to invent it myself. Medicare gives the claim denial ANSI codes for a claim missing this information and the broad list of services that have this requirement, I just can't find a specific list.

Thank you all for your responses!

 

[AmandaBriggs]

I have a feeling that the term "referral" is being used instead of the proper term "order". Any procedure or test will need a signed order by the requesting physician. This includes, labs, radiology, surgical procedures, etc. Even EKGs done in-house on cardiology patients need a valid, signed order or clear intent for the service to be done in the patient's chart. Consults are the only thing that requires a true "referral" from a CPT standpoint as far as I am aware.

 

[drsnpatil]

Referring physician

Hi Friends,

I am looking for list of CPT codes or supportive document regarding referring physician requirement on Part-B claims.