Pediatric Coding Alert

Question: After a mom had seen three other physicians for a patient's unresolved thrush and recurrent upper respiratory infections (URI), the parent requested an opinion from our double-certified internist and pediatrician who diagnosed the new patient with geographic tongue and poor eating habits including a low protein diet. The mom plans on remaining with our practice. The physician wants me to code this as a second opinion. Is there an E/M code for second opinion? Alabama Subscriber Answer: CPT no longer contains codes for second opinions or confirmatory consults including requests for opinions from a patient. You would instead use an office visit code (99201-99215, "Office or Other Outpatient Visit") linked to the definitive diagnosis code(s), such as geographic tongue (529.1) and/or feeding difficulties and mismanagement (783.3), other nutritional deficiency (269.8), and/or dietary surveillance and counseling (V65.3). Tip: If the total counseling minutes comprise more than 50 percent of the [...]