Otolaryngology Coding Alert

Question: Our ENT specialist handled the preoperative consultation for a surgical case and was asked to see the patient again after surgery. Can we bill an E/M service for this?

Washington Subscriber

Answer: If the surgeon asks the ENT back after surgery, you can bill an E/M service for this. Whether you can report a consult (99241-99255) depends on the payer. CPT places no limitation on how you use of consultation codes before and after surgery but the consult always must be medically necessary.

However: Medicare does not recognize consultations, as of Jan. 1,2010. Instead, you must report outpatient (99201-99215) or inpatient (99221-99233) E/M services in place of consult codes to Medicare.

-- Answers to You Be the Coder and Reader Questions reviewed by Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CENTC, CHCC, president of New Jersey-based CRN Healthcare Solutions.