Magazine article Medical Economics

Answers to Your Questions about . .

Magazine article Medical Economics

Answers to Your Questions about . .

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Additional consults

I saw a patient in my office in January for a consultation, and then again a few weeks ago for another consult. How often can I submit consult codes for the same patient? Can I bill a consultation for both visits?

Yes. The outpatient consultation codes (99241-99245) don't have oudined restrictions regarding how frequently you can use them, and the patient doesn't need to present with a new problem for you to bill for an additional consult.

According to CPT 2007, "if an additional request for an opinion or advice regarding the same or a new problem is received from another physician or other appropriate source and documented in the medical record, the office consultation codes may be used again."

As with the original consultation, when you perform an additional consult for a given patient, be sure you meet all of the consultation requirements: the request documented in the medical records of the requesting and the consulting physician, the patient evaluation, and the report returned to the requesting provider.

Preventive counseling

I spent 30 minutes with an established patient discussing and prescribing birth control pills during a preventive medicine counseling session. I went over the differences between the pill, the patch, and other birth control devices as well. Which ICD-9-CM codes should I report for the visit?

Report 99402 (preventive medicine counseling . . .) and link it to V25.01 (encounter for contraceptive management . . .).

Because 99401-99404 (preventive medicine, individual counseling) are time-based codes, you must document the amount of face-to-face time spent counseling. You'll stand a better chance of convincing payers to reimburse you for the counseling if you're able to provide particulars on the content of the discussion and reason why you prescribed a certain contraceptive. Your documentation for the counseling visit should include references to pamphlets or other materials you reviewed with the patient. …

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