Wiki Urologist referring to a UroGyn in the same practice???

[sarahhess218@yahoo.com]

Hello,

We have a Urologist that will be referring to a Uro/Gyn and both are under the same tax ID. Can the Uro/Gyn bill consult codes to the commercial payers?

Thanks so much for your help

Sarah

 

[mhstrauss]

Hello,

We have a Urologist that will be referring to a Uro/Gyn and both are under the same tax ID. Can the Uro/Gyn bill consult codes to the commercial payers?

Thanks so much for your help

Sarah

Several issues come into play with your question. The title of this thread is "Referring to", but your question is in regards to a consult. There is a big difference between these two. Is the Uro intending to refer the patient to the Uro/Gyn, with the intention that the Uro/Gyn will take over treatment? If so, then this is not a consult; rather, it is a Transfer of Care. The code selection then comes down to New vs Establ. If the Uro/Gyn is registered under a subspecialty taxonomy code, per 2013 CPT Guidelines, a Subspecialist can bill a New Patient Code, even if in the same practice. If the Uro/Gyn is not registered with a subspecialty taxonomy, an established patient code will be used.

If the Uro intends to follow up with the patient and continue treating under the advice of the Uro/Gyn, that is a true consult. In this case, a consult code can be used, regardless of whether or not it is the same specialty/subspecialty or same practice/different practice.

Here is an article, if you'd like a solid resource:

http://www2.aaos.org/bulletin/aug99/cod.htm

Hope this helps!

 

[sarahhess218@yahoo.com]

I just used the wrong wording, I am taking about true consults. I am just wanting to be sure that the Urologist can request a consult from a Uro/Gyn that works under the same Tax-ID.

Thanks,
Sarah