Advanced Search

Neurology & Pain Management Coding Alert

Reader Questions:

Give Credit for Opinions While in the ED

Published on Fri Oct 22, 2010

Question: What may I report if our neurologist is asked for an opinion on a patient's condition while on call for an emergency department (ED)? Maryland Subscriber Answer: You may report 99241-99245 (Office consultation for a new or established patient ...) for this type of consultation. Consultations may occur in any outpatient environment, including the ED, which is an outpatient site-of-service. For the service to qualify as a consultation, the treating physician in the ED must specifically request the neurologist's opinion. Keep the consultation requirements straight with these basics. The five R's of a consultation are as follows: - Reason: Both the requesting physician and consulting neurologist must document a medically necessary reason and request for a consultation. But the consultant doesn't have to verify that the requesting physician did so. In the hospital or where the medical record is shared, it is a good idea to verify a request for [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Neurology & Pain Management Coding Alert

View All