difference help

[cbell9]

I am trying to provide my physicians in writting the difference between a office consultation and a new patient office visit. Can you help me to find this information.

Thank you
Candace

 

[RebeccaWoodward*]

Specifically, a consultation service is distinguished from other evaluation and management (E/M) visits because it is provided by a physician or qualified nonphysician practitioner (NPP) whose opinion or advice regarding evaluation and/or management of a specific problem is requested by another physician or other appropriate source.

•A request for a consultation from an appropriate source and the need for consultation (i.e., the reason for a consultation service) shall be documented by the consultant in the patient’s medical record and included in the requesting physician or qualified NPP’s plan of care in the patient’s medical record;

•After the consultation is provided, the consultant shall prepare a written report of his/her findings and recommendations, which shall be provided to the referring physician.

Straight from the mouth of Medicare...

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

Section 30.6.10 goes into to further detail.

 

[FTessaBartels]

Why is patient sent to you?

Rebecca's information and links are absolutely perfect.

But in plain English ...

If a physician sends a patient to you to get your advice on how the first physician should handle an issue, it's a consultation.

If a physician sends a patient to you to have you treat/fix an issue or perform a diagnostic test (e.g. colonoscopy) it is NOT a consult.

Hope that helps.

F Tessa Bartels, CPC, CEMC