Base Charging for Consult and Epi Patch Placement on Several Circumstances
Key: Verify vital details with the anesthesiologist before coding the case Bottom line: Read the referral carefully, says New Jersey coding consultant Jann Lienhard, CPC. If it asks the anesthesiologist to "consult and treat" the patient, then she says billing a consult would be fine. But if it asks the anesthesiologist to "treat and follow," Lienhard says this would be a new patient or established patient visit instead of a consult.
Look at the entire situation to determine the medical necessity of a consultation and whether you should charge for both the consultation and epi blood patch placement. Consider these scenarios from South Carolina coding consultant Julee Shiley, CPC:
If the blood patch is administered, report 62273 and append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the appropriate consultation code (from 99251-99255). If the anesthesiologist determines that the blood patch will not be beneficial, only report the consultation code.
