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Consultation

Hari Posted Thu 09th of May, 2019 08:10:59 AM
Hi, if a PCP refers a patient to GI specialist, is it okay to take the consultation (do the consult services) by Registered NP of the same facility (same group) on behalf of MD and do the consultation services. Can we bill consult under NP. Can you please any authenticated document or weblink supporting the answer.
SuperCoder Answered Fri 10th of May, 2019 11:34:25 AM

Hi,

Thanks for your question.

When requested by a physician or other appropriate source, a consultation may be provided by a physician or qualified nonphysician practitioner (NPP). In order to be a qualified NPP, performing a consultation service must be within the scope of practice and licensure in the state in which the NPP practices.

Please go through with the links provided below:

https://www.supercoder.com/coding-newsletters/my-part-b-coding-alert/reimbursement-step-carefully-when-npps-bill-for-consults-article

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1725B3.pdf

Hope this helps.

Thanks.

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