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Consult or transfer of care??

  1. #1
    Default Consult or transfer of care??
    Medical Coding Books
    I believe I know this answer...but I just want to make sure this correct.

    If we see a new patient from another state who saw their PCP and advised that they come to us for their follow-up care, this would be a new patient not a consult, correct??

    I work for bariatric surgeons and this particular patient had gastric bypass in 2008, moved to our area, when her PCP recommended our physicians for follow up of her care.

    Even though the doctor dictates it at the request of ...., renders an opinion, and sends the doctor a response, it is still transfer of care???

    Thanks in advance for your help!


  2. #2
    I agree, transfer of care.

    Laura, CPC

  3. #3
    Transfer of Care per CMS is when the PCP or qualified NPP requests that another Physician or qualified NPP take over the responsibility for managing the patients' complete care for the condition and does not expect to continue treating or caring for the patient for THAT CONDITION......

    Is transfer of care to me......
    Marilyn CPC, CPC-H, CEMC

  4. #4
    I agree, very obvious transfer of care. The patient is not going back to the prior provider for continued care. S/he is now your provider's patient and that was the intent from the beginning.

  5. Default
    Definitely a transfer of care. We go round and round with our docs when a PCP "refers" a pt to us, the PCP is not asking for our doc to do a consultation, they are asking the doc to take over the care for a particular dx that they cannot treat. The May 2009 Coding Edge has an excellent article on consultations for further info.
    Ann Marie CPC
    Watertown, CT

  6. #6
    Thanks for the responses and help. That is actually what I thought...just wanted to be sure.


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