Patient care hinges in part on adequate and timely information exchange between treating providers. Referral and reply letters are common means by which doctors and nurse practitioners exchange information pertinent to patient care. Ensuring that letters meet the needs of letter recipients saves time for clinicians and patients, reduces unnecessary repetition of diagnostic investigations, and helps to avoid patient dissatisfaction and loss of confidence in medical practitioners.
As a Nurse Practitioner (NP) you will need to know the difference between a consultation and a referral for treatment, when ordering and when carrying out consultations or referrals.
Consultations
A consultation is a request for opinion or advice, so that the requestor can manage the patient. A consultation is billed under one of the consultation codes listed in Physicians’ Current Procedural Terminology (CPT) (99241-99245 for outpatient of office consultations). If the NP is the consultant, the NP should document the request for a consultation, the reason for the consult, and the NP’s evaluation and recommendations.
When an NP requests a consultation from another provider, the N P should request “consultation” on the referral form, rather than “referring.”
Referrals:
A referral is made when the referring provider wants to turn the management of the patient over to the referred-to provider, at least for the current complaint.
When a NP refers a patient, the NP should state on the referral form that the NP is “referring the patient for evaluation and treatment.” The referred-to provider will bill an evaluation and management code, rather than a consultation code.
Writing Assignment: Consult: Write up a consult request and include all key elements.
Ms. Perez has been referred to Ms. Wilson FNP-C,APRN, MSN for consultation regarding eczema unresponsive to treatment in the past six months.
Document the evaluation and recommendations for how Ms. Wilson FNP-C,APRN,MSN should deal with the consultation request and bill a consultation code.
Expert Solution Preview
Introduction: In medical practice, it is essential to have proper communication and information exchange between treating providers to provide adequate patient care. Two common means of exchanging information are referral and consultation letters. NPs must understand the difference between a consultation and a referral to make appropriate decisions when ordering or carrying out either. In this writing assignment, we will focus on writing a consultation request and its key elements.
Answer: A consultation request should include all the necessary details to help the consultant assess and make recommendations regarding the patient’s care. The request must include the patient’s demographics, relevant medical history, reason for the consultation, and any necessary clinical findings or test results. The consultant’s name, specialty, and contact information should also be included in the request.
Based on the case, the consultation request for Ms. Perez’s eczema unresponsive to treatment should include her demographics, current medications, and treatment history in the past six months. The request should specify the reason for consultation and any relevant clinical findings, such as the severity and duration of eczema symptoms. Ms. Wilson FNP-C, APRN, MSN should document the request for the consultation, the reason for the consult, and the recommended evaluation and treatment plan for the patient. To bill a consultation code, Ms. Wilson FNP-C, APRN, MSN should provide an opinion or advice to the referring provider on how to manage Ms. Perez’s eczema condition.
#Referral #consultation
