Wiki Referring Dr. question

[molly3]

I code for a pediatric surgeon and need to know when I'm posting his surgical charges do I list him as the referring doctor or the doctor who actually referred the patient to our office. I believe there are some scenarios where the doctor performing a procedure is listed as referring doctor, but don't know the general rule on this. Also, if you can tell me where to find something by CMS in regards to this, that would he helpful too.

Thanks,
Jan

 

[philipwells]

I'd use the doctor that actually referred them to the office. Now if it's a Medicaid patient, more than likely it will have to be the PCP in the referring physician spot, which usually is the one that refers the patient anyways.

I doubt you will see any Medicare patients but in the situation that you do, we would always use the performing provider in the referring provider spot as well.