Source for a Consult

March 31, 2016

What is an appropriate “source” for a consult? I asked at a recent workshop and the instructors did not have an answer.

The guidelines for a consultation (inpatient or outpatient) must be requested by a physician, or qualified non-physician practitioner. Guidelines are not clear regarding individuals who may be considered an appropriate source, but some likely examples include a physician assistant, nurse practitioner, doctor of chiropractic, physical therapist, occupational therapist, speech language therapist, psychologist, social worker, lawyer, or insurance company. Do not report a consultation requested by a patient or family member, etc., using a consultation code.

*This response is based on the best information available as of 03/31/16.

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Coding Coaches