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Consultation Request to a Specialist

  1. Question Consultation Request to a Specialist
    Medical Coding Books
    Specialists in our area are requesting copies of charts prior to scheduling an appointment. Some patients have more than 1 chart and it is quite time consuming to copy and send. The physician in the office always writes up a consult request with her concerns, why the referral, and copies of any diagnostic tests already complete that are related to the problem. Is there a CPT code that they are billing for reviewing these charts? I know they have to have a request for a consult in the chart in order to bill the consultation cpt code, but why the whole chart? Thanks.

  2. #2
    I do not think that most specialists are asking for records so that they can bill for reviewing them. I do think that they request these because it is a waste of their time if they do not have the needed records to review at the time of service. It is highly unlikely that an entire record should be needed. I would recommend that your office adopt a policy of copying only those records and results pertinent to the reason for the specialist consult, along with a medication list and history or problem list that is faxed to the specialists office at the time the appointment is made (patients often forget to take them with them when given in hand). I would let the specialists know this is your offices procedure and if any further information is needed, they can feel free to request what they may need in addition. I think this sounds like some specialist staff members going overboard for a common small problem of not having any records at all. Copying records for the purpose of continuity of care is permissible under HIPAA without a patient signature, but they obviously would not need every single piece to address one issue or concern. Good luck!

  3. Default
    Thanks for your input. I agree with you about the staff going overboard when requesting records.

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