Referral is a requirement of insurance companies (started with HMOs, but has expanded to a lot of carriers).
A request for a consultation is just that - one provider requesting advice or opinion from another provider on the management of a problem/issue.
There USED to be a code for second-opinion consults. No longer.
If the patient initiaed the visit with your doctor, it is NOT a consultation. It is a new or established patient visit (depending on whether the patient has received any services by your physician or another physiciain of the same specialty in the same practice within the last three years).
Hope that helps.
F Tessa Bartels, CPC, CEMC
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