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Referral

  1. #1
    Location
    Long Island/New York
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    1,271
    Default Referral
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    I have a doc that feels there is a specific E/M code for when a doc refers a patient to him WITHOUT a consultation being done. Is there any documentation that I can show him that there is no such code...Thanks..

  2. #2
    Location
    Columbia, MO
    Posts
    12,558
    Default
    just use the CPT book to demonstrate all available visit levels. These are the only visit levels available so what you have is an ov either new or estb.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Long Island/New York
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    Quote Originally Posted by mitchellde View Post
    just use the CPT book to demonstrate all available visit levels. These are the only visit levels available so what you have is an ov either new or estb.
    ok...thanks..

  4. Cool Referral
    Has anyone thought about the fact that the term "Referral" is not listed in CPT? There is a reason behind Medicare's revision of "Consultations". "Referrals" contribute to the transfer of care utilized in Medicare's policy. Medicare is still consider a "payer" and write their own rules. There are distinct differences between AMA CPT coding policy and applied insurance carrier's reimbursement rules. Please stop thinking they are the same, medical coding is reporting the service to the insurance carrier. If they were the same, insurance carrier's would not have a need to have separate reimbursement policies for contracted providers.

    Just something to think about.

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