tci General Surgery Coding Alert - 2015 Issue 3

Reader Question: Meet Criteria to Bill Consultation

Question: A new patient came to see a surgeon in our practice to discuss whether she should have a colonoscopy. She said that she thought she might need the procedure because she was worried about bowel habit changes, which she had told her primary physician about. Should we bill the visit as a consultation? Colorado Subscriber Answer: No, you should not consider the encounter a consultation because the primary physician did not ask your surgeon for an opinion, and your surgeon is not obligated to send results to the primary physician. By definition, according to CPT®, a consult is...

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