General Surgery Coding Alert
Patient-Generated Second Opinion Isn't a Consult
Question: I know that CPT deleted the confirmatory consult codes for billing second opinions, but I-m not sure how we should report these services now. How should I bill our surgeon's work performing a second opinion?
Ilinois Subscriber
Answer: If a patient presents to your practice and requests a second opinion, you should report the appropriate E/M code (99201-99205 for new patients, and 99212-99215 for established patients). Because patients generate most second-opinion requests, you should treat these office visits as you would any other E/M visit.
Caveat: In some rare cases, you may encounter a physician-generated second-opinion request that can qualify as a true consultation.
According to CMS Transmittal 788, dated Dec. 20, 2005, -In a facility setting, a second-opinion consultation arranged through the attending physician shall be reported by a physician/qualified NPP using an appropriate initial inpatient consultation code [99251-99255] when the consultation requirements are met. When consultation requirements are not met, the subsequent hospital care codes (99231-99233) in the hospital setting and the subsequent NF care codes (99307-99310) in the NF setting shall be reported.-
General Surgery Coding Alert
- Will New Mastectomy Codes Revolutionize Your Claims? Find Out Now
Surgeon intent still matters most for excisions CPT 2007 creates a whole new subsection dedicated [...] - What You Must Know About Revised Consult Guidelines
Remember: 1 consult per inpatient stay is the limit CPT 2007 has added instructional text [...] - YOU BE THE CODER:
Do Telephone Codes Pay?
Question: I recently noticed that CPT contains E/M codes specifically for telephone services. Our surgeon [...] - 2007 Skin Prep Codes Could Mean More Fitting Payments
Anatomic location is now a factor for graft preparation CPT 2007 brings you four new [...] - READER QUESTION:
Watch Mastectomy/Lymph Excision Unbundle
Question: When the surgeon removes lymph nodes during a partial mastectomy, may we report the [...] - READER QUESTION:
Patient-Generated Second Opinion Isn't a Consult
Question: I know that CPT deleted the confirmatory consult codes for billing second opinions, but [...] - READER QUESTION ~ Check Fee Schedule for Global-Period Info
Question: I see a lot of discussion about -global periods,- but I cannot find anything [...]
