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Thread: difference help

  1. #1
    Join Date
    Apr 2007

    Question difference help

    AAPC: Back to School
    I am trying to provide my physicians in writting the difference between a office consultation and a new patient office visit. Can you help me to find this information.

    Thank you

  2. #2
    Join Date
    Apr 2007
    North Carolina


    Specifically, a consultation service is distinguished from other evaluation and management (E/M) visits because it is provided by a physician or qualified nonphysician practitioner (NPP) whose opinion or advice regarding evaluation and/or management of a specific problem is requested by another physician or other appropriate source.

    •A request for a consultation from an appropriate source and the need for consultation (i.e., the reason for a consultation service) shall be documented by the consultant in the patient’s medical record and included in the requesting physician or qualified NPP’s plan of care in the patient’s medical record;

    •After the consultation is provided, the consultant shall prepare a written report of his/her findings and recommendations, which shall be provided to the referring physician.

    Straight from the mouth of Medicare...


    Section 30.6.10 goes into to further detail.

  3. #3
    Join Date
    Apr 2007
    Milwaukee WI

    Default Why is patient sent to you?

    Rebecca's information and links are absolutely perfect.

    But in plain English ...

    If a physician sends a patient to you to get your advice on how the first physician should handle an issue, it's a consultation.

    If a physician sends a patient to you to have you treat/fix an issue or perform a diagnostic test (e.g. colonoscopy) it is NOT a consult.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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