Results 1 to 7 of 7

Points for Referring Patient elsewhere

  1. #1
    Harrisburg, PA
    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
    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
    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
    North Carolina
    I agree with Laura...

  5. #5
    Harrisburg, PA
    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
    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
    Milwaukee WI
    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

Similar Threads

  1. referring physician
    By joy63 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 06-10-2014, 08:10 AM
  2. Replies: 8
    Last Post: 06-25-2013, 09:13 AM
  3. Referring Doctor
    By YesicaRuedas in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 04-29-2013, 10:40 AM
  4. Referring physician
    By mlb2152 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 09-14-2011, 09:18 AM
  5. Referring Dr Info
    By Partha in forum Medicare Regulations
    Replies: 1
    Last Post: 01-08-2010, 09:13 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.