Chart Records Review
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My physician referred a patient out to see a NeuroPsych. We received back
a 14 page consult report.
My physician now wants to bill the patient a "records review/99358" for the
time he spent in reviewing the received consultation report.
I don't believe we can bill for him to review a report for a referral that
we made?
Cheryl Sarnowski, Administrator
2137 West State Road 434
Longwood, FL 32779-4983
Email: Cheryl@headache-institute.com
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x 114. Thank you.
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My =
physician referred a patient out to see a NeuroPsych. We =
received back a 14 page consult report.
My physician =
now wants to bill the patient a “records review/99358” for =
the time he spent in reviewing the received consultation =
report.
I don’t believe we can bill for him to review a =
report for a referral that we made?
Cheryl Sarnowski, =
Administrator
2137 West State =
Road 434
Longwood, FL =
32779-4983
Email: =
Cheryl@headache-institute.com
This =
electronic mail/email message and any attachments may contain =
confidential and/or private information intended solely for a specific =
individual and purpose and is protected by law. If you are not the =
intended recipient of this email, you are hereby notified that any =
disclosure, copying, or distribution of this email and any attachments, =
or the taking of any action based thereon, is strictly prohibited. =
If you have received this email in error, please notify the sender by =
reply email or call 407-644-3737 x 114. Thank =
you.
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Comments
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Cheryl:
You will get a lot of answers for this, including 'Medicare doesn't cover' -
so it just requires putting it in perspective.
There are several thoughts/questions:
-Will your physician use the report to treat the patient, or is the report
outlining the treatment the consultant will provide to the patient, (if the
patient chooses to continue care with the consultant)?
-Part of an E/M service scoring can be attributed to records review. Is
your physician contacting the patient to come in and discuss the
consultant's report? If so, this could meet documentation requirements to
recover some compensation for the records review.
Billing a patient for a service has multiple parameters, including: Is it
covered by the patient's health plan? Can you bill outside of the plan per
your contract? Was the patient informed that there may be a non-covered
charge they can be obligated to?
Karen A. Hurley, BS, CMM, CPC, CNA
President, HPMSI
PO Box 409
Parrish, FL 34219
Tel: (941) 776-4822
Fax: (240) 368-0059
Web: www.hpmsi.com
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See below
Cheryl Sarnowski, Administrator
c/o Marc Irwin Sharfman, MD PA
2137 West State Road 434
Longwood, FL 32779-4983
Phone: 407-644-3737 x 114
FAX: 407-644-3009
Email: Cheryl@headache-institute.com
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If that's the case, he would have the patient come back for another visit to
discuss a treatment plan and the records review is part of the E/M scoring
process (as long as it is documented).
If the patient is self-pay, then you have no restrictions on what you charge
the patient, but would still need to meet the state's guidelines for the
practice of medicine's documentation requirements. Therefore, you should be
able to charge for records review, however it is good business to inform
patients in advance of possible additional charges.
Keep in mind that some self-pay patients are applying for state Medicaid,
and if you are participating - and the coverage is retroactive, this could
all become moot (charging for records review).
Karen A. Hurley, BS, CMM, CPC, CNA
President, HPMSI
PO Box 409
Parrish, FL 34219
Tel: (941) 776-4822
Fax: (240) 368-0059
Web: www.hpmsi.com
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Thanks Karen . Couldn't agree with you more.
I am comfortable billing records review when it's warranted and perhaps
outside of the E/M (and within guidelines) .. I was just concerned about
billing for him to review a consult report from a doctor that we asked to
provide the consult on and then bill patient for my physician to review. In
this particular case I just felt it should be part of the next E/M etc.
Cheryl Sarnowski, Administrator
c/o Marc Irwin Sharfman, MD PA
2137 West State Road 434
Longwood, FL 32779-4983
Phone: 407-644-3737 x 114
FAX: 407-644-3009
Email: Cheryl@headache-institute.com
wouldn't think this is any different from receiving any other consult he
received that was 3 or 4 pages. This code is used most often when a new
physician comes on board with a complicated hospital case or the patient is
extremely complex. I would prefer to be conservative rather than try to
prove my point should the case be reviewed.
"Prlonged evaluation and Management service *before and/or after direct
(face-to-face)* patient care ." That says it all in my opinion.
Donna Fickes
Patient Account Manager
Center for Arthritis & Rheumatic Diseases PC
757 461 6997 ext 2
djfickes@centerforarthritis.com