shannon789
New
I have been trying to research this & have found nothing so far. I work at a multi-specialty clinic & we currently have a situation where Radiology is sending patients to our Surgical Oncologist for a “surgical consult.” Do you think it's okay for a Radiologist to be the requesting physician on a consultation (E&M codes 99241—99245)?
Our first response was no, because Radiologists, like Pathologists, do not treat patients so the logic is that they cannot ask for recommendations on treatment. But then if you think about it some more, if a Radiologist does an x-ray & sees an abnormality & feels that further evaluation may be necessary, he is not able to order any further studies. So he has to ask another physician to see the patient & recommend whether or not further studies are warranted. A consult can be requested for recommendations on treatment &/or evaluation, so you could argue that the Radiologist is requesting the other physician's opinion on whether or not the pt. requires further evaluation.
A typical scenario is that the patient's PCP finds a lump in her breast, so the PCP orders a diagnostic mammogram. Radiology performs the mammogram, confirms the presence of an abnormality, and sends the patient to Surgical Oncology. When Surgical Oncology sees the patient, they are billing a consultation w/the requesting physician listed as Radiology. Surgical Oncology reviews the films already taken & usually orders an MRI, so the patient is then sent back to Radiology.
I would appreciate anyone's help &/or advice. Thanks!
~Shannon
Our first response was no, because Radiologists, like Pathologists, do not treat patients so the logic is that they cannot ask for recommendations on treatment. But then if you think about it some more, if a Radiologist does an x-ray & sees an abnormality & feels that further evaluation may be necessary, he is not able to order any further studies. So he has to ask another physician to see the patient & recommend whether or not further studies are warranted. A consult can be requested for recommendations on treatment &/or evaluation, so you could argue that the Radiologist is requesting the other physician's opinion on whether or not the pt. requires further evaluation.
A typical scenario is that the patient's PCP finds a lump in her breast, so the PCP orders a diagnostic mammogram. Radiology performs the mammogram, confirms the presence of an abnormality, and sends the patient to Surgical Oncology. When Surgical Oncology sees the patient, they are billing a consultation w/the requesting physician listed as Radiology. Surgical Oncology reviews the films already taken & usually orders an MRI, so the patient is then sent back to Radiology.
I would appreciate anyone's help &/or advice. Thanks!
~Shannon