Urology Coding Alert

According to CPT Codes, "A 'consultation' initiated by a patient and/or family, and not requested by a physician," is reported using the confirmatory consultation codes (99271-99275, Confirmatory consultation for a new or established patient).
 
You can also code for these consults when an insurer or other physician seeks a second or third opinion. If an insurer requests the consult to determine medical necessity prior to covering a procedure or service, report the appropriate code with modifier -32 (Mandated services) appended.
 
CPT designates that confirmatory consults are for "rendering an opinion and/or advice only. Any services subsequent to the opinion are coded at the appropriate level of office visit, established patient, or subsequent hospital care."
 

Because you can't bill confirmatory consultations - unlike other consultation codes - on time alone, use the CPT codes for new patient office visits (99201-99205) when billing a confirmatory consult (second opinion) based on time. Medicare's recent policy has suggested this coding method.
 Medicare will also allow in-office consultations and/or second opinions from one's partner who may have a specific expertise in some facet of urology. Remember that all consultation criteria must again be satisfied by the second within-office consult, and in these cases the required written consultation note may be added to the common office chart.