Neurology & Pain Management Coding Alert

Question: A patient was seen in the emergency room for neck pain. The ER doctor asked my neurologist to see the patient for an -eval and treat- in our office on the same day. How should I code this?

Georgia Subscriber

Answer: If your neurologist has not had a face-to-face service with this patient within the past three years, this would be a new-patient encounter with transfer of care as far as your coding is concerned. Choose a new-patient E/M code (99201-99205, Office or other outpatient visit for the evaluation and management of a new patient,which requires these 3 key components ...). If the patient is already a patient of your neurologist, then use the appropriate established-patient code (99211-99215).

There is most likely no consultation E/M service for this scenario -- the ER physician is not asking for your neurologist's opinion but rather is transferring care of the patient's condition.