EM Coding Alert

Question: A doctor securely emailed patient information to another physician for her opinion on the condition of the patient. Is there an E/M code that I can use for this?

Colorado Subscriber

Answer: You can use the appropriate CPT® code from the 99446-99449 (Interprofessional telephone/Internet assessment and management service provided by a consultative physician including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional; …) range. The codes became available for telephone and internet assessment and management services on Jan. 1, 2014.

When your physician relies on the phone or internet for consults, you have four time-based codes to choose from:

• 99446 — … 5-10 minutes of medical consultative discussion and review
  
• 99447 — … 11-20 minutes of medical consultative discussion and review
  
• 99448 — … 21-30 minutes of medical consultative discussion and review
  
• 99449 — … 31 minutes or more of medical consultative discussion and review.
  

These codes come in handy the more physicians lean on the internet for assistance with consults between other healthcare professionals and patients.

Catch: Since these codes are consultation codes, there has to be a written report provided to the receiving physician in order to qualify the use of the code, as stated in the code descriptors. Additionally, you will want to check with your payers to see if these codes are covered. Payers often don’t cover non face-to-face services with the patient. 

If, however, the initiating physician wants the consultant to see the patient, the face-to-face consultation is something most payers do pay for and if a note back to the requester is sent, the consultation would be more appropriate and less likely to be denied.