3 R's
I do not mean to be picking on you, Kristen, but this is exactly why Medicare has decided to stop honoring the consultation codes.
Referrals are a requirement of managed care (HMOs mostly).
Requests for consultation are a very specific thing. One doctor is asking another doctor for advice on opinion on the treatment/management of a problem. The intent is that the consulting physician will report findings and recommendations for treatment to the requesting physician who will either take the consultant's advice or not.
Just because you have a "referral" on file does not mean you have a request for a consultation. And, frankly, just because the "consultant" has documented a request from Doctor PCP doesn't mean that this wasn't a transfer of care (e.g. patient referred FOR a colonoscopy).
If you physicians are legitimately being asked for a consultation, then their documentation MUST include the fact that they have been asked to consult on X problem by Y doctor, and they must provide a copy of their findings and recommendation to the requesting doctor. If you do not have ALL these requirements, you do not have a consultation.
Hope that helps.
F Tessa Bartels, CPC, CEMC