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Points for Referring Patient elsewhere

  1. #1
    Location
    Harrisburg, PA
    Posts
    38
    Default Points for Referring Patient elsewhere
    Medical Coding Books
    When performing an E/M audit does the physician receive any points in medical decision making under Amount and/or Complexity of Data Reviewed for referring a patient to another physician.

  2. #2
    Default
    I do not believe that a physician is given points for referring a patient, that is part of managing their patient...
    Felicia A. Thomas, CPC
    Atlanta, GA

  3. #3
    Default
    Depending on who/why they are sending them to and for what reason they could get credit under the table of risk.

    Laura, CPC, CEMC

  4. #4
    Location
    North Carolina
    Posts
    3,126
    Default
    I agree with Laura...

  5. #5
    Location
    Harrisburg, PA
    Posts
    38
    Default
    So lets same patient was see by his PCP and found to have rectal bleeding. PCP sent pt to gastroenterologist to be evaluated.

  6. #6
    Default
    That would most likely fall under moderate for either 1 of 2 reasons.

    1. You could consider that and undiagnosed new problem or
    2. If the intent is for a colonoscopy to be done, it would be a diagnostic endoscopy w/no identified risk factors.

    Unless of course there are risk factors in which case you would get high.

    Laura, CPC, CEMC

  7. #7
    Location
    Milwaukee WI
    Posts
    4,466
    Default Data points
    IF your documentation said something along lines of: "I'm going to talk to Dr X in Cardiology about this..." then I'd give data points for "discussion of case with another health care provider."

    F Tessa Bartels, CPC, CEMC

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