Charge Consultations for Your Allergists Diagnostic Work

Your allergist deserves more than a pat on the back for helping another physician diagnose a patient with hypersensitivity pneumonitis. You can report this service and receive proper reimbursement for your physician's time with consultation codes 99241-99255.
Even if your allergist has never directly diagnosed one of your patients with hypersensitivity pneumonitis (HP), she has probably offered her consultative services to a primary-care provider (PCP), so you should freshen up on how to get the most out of your consultations with HP patients.

PCPs commonly request consultations from allergists for patients with symptoms such as fever (780.6), shortness of breath (786.05), chest pain (786.50), weight loss (783.21) and fatigue (780.79). Hypersensitivity pneumonitis is usually considered a diagnosis by allergists but is sometimes missed by generalists, says Anthony Marinelli, MD, FCCP, chairman of the American Thoracic Society's Clinical Practice Committee. Since the PCP's request for consultation is a common occurrence, you should know how to get the most out of your time spent consulting for HP patients.

A general practitioner's office often confirms that a patient has a persistent cough, abnormal PFTs, abnormal x-rays, and a positive methacholine test, Marinelli says. With this information, the PCP may be quick to diagnose asthma, which has similar symptoms and test results.
An allergy specialist, however, will consider other possibilities in the consultation report that correlate with a positive methacholine test and will always consider context. You should report consultation codes (99241-99255) for your allergist's assessment.
 

- Published on 2003-03-01