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Consult Requests

  1. #1
    Default Consult Requests
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    Would "medical management and surgical clearance" -- be a valid reason for a consult. Also, where can I get a list of valid reasons for consults? My physicians will put any reason down for a consult and I know some of them are not valid.

    Thank you.

  2. #2
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    North Carolina
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    Sugical clearance- Possible......

    G. Consultation for Preoperative Clearance

    Preoperative consultations are payable for new or established patients performed by any physician or qualified NPP at the request of a surgeon, as long as all of the requirements for performing and reporting the consultation codes are met and the service is medically necessary and not routine screening.

    As for a list of reasons...the validity of the consult will be dependant on the intent for the visit. (The 3 R's)

    30.6.10 is a good resource for this information. It also provides some examples of what does/doesn't constitute a consult

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

  3. #3
    Default Consult Requests
    Quote Originally Posted by rebeccawoodward View Post
    Sugical clearance- Possible......

    G. Consultation for Preoperative Clearance

    Preoperative consultations are payable for new or established patients performed by any physician or qualified NPP at the request of a surgeon, as long as all of the requirements for performing and reporting the consultation codes are met and the service is medically necessary and not routine screening.

    As for a list of reasons...the validity of the consult will be dependant on the intent for the visit. (The 3 R's)

    30.6.10 is a good resource for this information. It also provides some examples of what does/doesn't constitute a consult

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

    Thank you

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