Consult verbiage

[renifejn]

"Patient X is referred by Not Named Unknown, MD for initial consultation of evaluation of nephrotic syndrome.

Would you code this as new pt visit since the 'requestor' is not listed?

Also, if the same statement above was given but the 'referred was replaced by 'requested' would this still be unacceptable?

thanks

[FTessaBartels]

You can't bill a consult unless you know the name of the requesting MD (and his/her NPI number, for that matter).

If you're in a hospital setting and the consulting MD at least gives you which service requested the consult (e.g. I've seen "asked by 4th floor hospitalist" or "asked by cardiology...") you can usually find out the name of the doctor on staff at the time (usually the orders are in the medical record, including the name).

So to answer your specific questions:
Would you code this as new pt visit since the 'requestor' is not listed? Yes

Also, if the same statement above was given but the 'referred was replaced by 'requested' would this still be unacceptable? Yes, because you don't know who the requesting physician is.

Ideal language (try to educate your physician about this) is:
Patient seen in consultation regarding xxxx, at the request of Dr Name.

It's really difficult, I know, to get doctors to stop using the word "referred."
S I G H.

F Tessa Bartels, CPC, CPC-E/M