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Radiology Coding Alert

What Does Medicare Consider a Transfer of Care?

Because Medicare's consultation coding guidelines hinge on whether a referring physician requests an opinion or transfers care, radiologists should note how CMS perceives transfers of care. Section 15506 B of the Medicare Carriers Manual defines a transfer of care:

"When the referring physician transfers the responsibility for the patient's complete care to the receiving physician at the time of referral, and the receiving physician documents approval of care in advance. The receiving physician would report a new or established patient visit depending on the situation (a new patient is one who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice, within the past 3 years) and setting (e.g., office or inpatient)."

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