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Re: Medicaid/Consultation
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Doo
Re: Medicaid/Consultation
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: 6347
Apr 3 07 1:40 PM
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My Recent Posts
Okay, let me explain what I meant.
Say you have a patient that is allowed one preventive visit per year. So you see the patient for their annual exam, and it comes back denied because the patient saw someone else earlier in the year. Do you accept the denial and bill the patient (or write it off if appropriate)? I wouldn't. I would doublecheck what the chart says and see if it meets criteria for a regular E&M. Just because you billed it the first time as a preventive visit doesn't mean that it was correct.
So if you check your chart, you need to see if what was done meets criteria for a regular E&M vs. a Consultation. Was there a written request (or written documentation of a request) from the surgeon for your doctor's opinion? Or did the patient just call and schedule a visit for a pre-op exam? If there is no
documentation of the request for your doctor's opinion by another doctor
, then it is not a consultation.
And furthermore, I would put a note in the chart stating what you did and why.
Sharon
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Medical Billing & Coding Education from the MAB
Continuing Education
Management Advice and Training
Questions Asked More Than Once
Help Wanted - Billing and Coding
Non Billing Talk
The Venting Area (Clean posts please)
Medical Coding and Billing News
Fraud and Abuse
Health Insurance - Provider Contracting
ERISA
Tricare
Workers' Compensation
General Medical Billing Questions
Appeals
Accounts Receivables (A/R)
Refunds
Auto Accident Issues
Medisoft Technical Support
Medical Software Technical Support Questions Other than Medisoft. No Investigation Questions!
General Medical Coding Forum
CPT Coding Questions
HCPCS Coding Questions
ICD-9-CM Coding Questions
Evaluation & Management Coding Questions
Acupuncture Billing and Coding
Ambulance Coding and Billing
Cardiology Coding and Billing
Chiropractic Coding and Billing
Dental Billing and Coding
DME Coding and Billing
Emergency Department Coding and Billing
Family Practice Coding and Billing
Hospital Inpatient and Outpatient Coding
Hospital Billing, Appeals and Collections
Internal Medicine Coding and Billing
Laboratory Coding and Billing
Ophthalmology Coding and Billing
OB-GYN Coding and Billing
Pain Management Coding and Billing
Pediatric Coding and Billing
Podiatry Coding and Billing
Physical Therapy Coding and Billing
Psychiatry Coding and Billing
Radiology Coding and Billing
Surgery Coding and Billing
Neurology Coding and Billing
Urgent Care Coding and Billing
Provider Compliance
Billing Center Compliance
HIPAA
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