Medical Billing Forum
Billing => Billing => : dmaney March 21, 2014, 02:16:47 PM
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My doctor recently saw an HMO patient that was referred by her PCP. Do I bill the E/M as a consult or normal new patient E/M? (my doctor communicated the results to the PCP and has taken over care of the patient). I'm thinking a consult. Is that right?
When my doctor sees this patient again, it's a regular established patient E/M?
In the case where a patient has not been referred, then it is a regular E/m. Right?
Don't want to make mistakes. Many thanks.
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Are you a coder or the biller? This is something that can't be answered based only on the info provided. Really the dr who was in the room , or a coder with access to the patient's medical record would have to decide if the specifications for a consultation or an E&M code.
Also, Medicare and many other insurances do not allow for consultation codes. Medicare advises providers to use E&M codes. Here is a link with more information on the consultation codes:
http://ep.yimg.com/ty/cdn/pmiconline/CONSULT-CODES.PDF
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Thank you!