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Consult Response

  1. #1
    Question Consult Response
    Exam Training Packages
    I have a question that I can't seem to find a definitive answer for. When billing a consult, does the response back to the requesting provider have to be a separate document from what is kept in the chart? Meaning, if the chart note also has the greeting for the letter, does that satisfy the consult requirements. Here's an example:
    March 28, 2008
    Olive Oyl
    Dob 01/01/12

    PRIMARY CARE PHYSICIAN: Pepe Lepue, MD 3 Tree Ln, Make Believe Forest, WA

    Dear Dr. Lepue:

    SUBJECTIVE: It was a pleasure today to see Olive Oyl at Midol Clinic.

    The note then goes on for 6 pages with the history, exam, and MDM. This one document is supporting the response back since a copy will be sent to the PCP. Is this OK??
    Last edited by SUEV; 05-16-2008 at 01:28 PM.

  2. #2
    Default Consult Response
    no it doesn't satisfy the 3 pertinent consult requirements...
    the consulting progress note needs
    1)referring MDs name (I am seeing said patient referred by Dr. blah blah because of/due to, etc.)
    2)full visit (HPI, EXAM, MDM-with opinion)
    3)response back to referring MD (CC: Dr. blah blah, I sent this consult back to Dr. blah blah, etc.)
    I hope this helps

    Quote Originally Posted by SUEV View Post
    I have a question that I can't seem to find a definitive answer for. When billing a consult, does the response back to the requesting provider have to be a separate document from what is kept in the chart? Meaning, if the chart note also has the greeting for the letter, does that satisfy the consult requirements. Here's an example:
    March 28, 2008
    Olive Oyl
    Dob 01/01/12

    PRIMARY CARE PHYSICIAN: Pepe Lepue, MD 3 Tree Ln, Make Believe Forest, WA

    Dear Dr. Lepue:

    SUBJECTIVE: It was a pleasure today to see Olive Oyl at Midol Clinic.

    The note then goes on for 6 pages with the history, exam, and MDM. This one document is supporting the response back since a copy will be sent to the PCP. Is this OK??
    Rachele Porter, AS, CPC, CPC-H, CEDC
    no weapons formed against me shall prosper

  3. #3
    Default
    Quote Originally Posted by SUEV View Post
    I have a question that I can't seem to find a definitive answer for. When billing a consult, does the response back to the requesting provider have to be a separate document from what is kept in the chart? Meaning, if the chart note also has the greeting for the letter, does that satisfy the consult requirements. Here's an example:
    March 28, 2008
    Olive Oyl
    Dob 01/01/12

    PRIMARY CARE PHYSICIAN: Pepe Lepue, MD 3 Tree Ln, Make Believe Forest, WA

    Dear Dr. Lepue:

    SUBJECTIVE: It was a pleasure today to see Olive Oyl at Midol Clinic.

    The note then goes on for 6 pages with the history, exam, and MDM. This one document is supporting the response back since a copy will be sent to the PCP. Is this OK??
    We've been audited by our local medicare carrier we are an Internal Med practice and what your presenting is exactly what most of our physicians do... and we passed our audit on consults...

    I also do some chart auditing for a neuro group who does the same thing.

    Some of the physicians will do a separate chart note and then a letter back to the referring physician. I guess you could check with that pt's insurance carrier for clarification; it is possible that each insurance has their own "rules" as to what they will and will not accept.

    Good luck,
    Last edited by rthames052006; 05-16-2008 at 04:41 PM.
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  4. #4
    Default
    Thanks for everyone's note. I realized after I posted it that my example didn't have the requesting physician documentation. It's good to know that these types of notes have passed audits!

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