Wiki Interprofessional Consults for eating disorders in teens

[ehlberg7575]

Hello, Pediatric office with providers that see a lot of teenage girls for weight managements for eating disorder / anorexia. Often times the provider has to be included on care management calls for their opinion and/or the pediatrician is requesting this call. The call or zoom encounter can exceed 30 mins of time spent discussing the individual patient and treatment plan. The care management team can consist of the psychiatrist, social worker, parents, etc. How are you billing for this? are you getting paid? The providers spend a lot of time in care coordination of the teen with these disorders and we are trying to see if this is reimbursable or not. Any suggestions/input are greatly appreciated? Thank you

 

[CBLENNIE]

You might look into Interprofessional Telephone/Internet/Electronic Health Record Consultations 99446-99449:

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The consultant should use codes 99446, 99447, 99448, 99449 to report interprofessional telephone/Internet/electronic health record consultations. An interprofessional telephone/Internet/electronic health record consultation is an assessment and management service in which a patient's treating (eg, attending or primary) physician or other qualified health care professional requests the opinion and/or treatment advice of a physician or other qualified health care professional with specific specialty expertise (the consultant) to assist the treating physician or other qualified health care professional in the diagnosis and/or management of the patient's problem without patient face-to-face contact with the consultant.​

Note codes 99446-99449 a verbal and written report to the patient's treating/requesting physician or other qualified health care professional is required. So, in addition to the call or zoom your provider would have to provide a written report to the requesting/treating provider to bill for these services.

These are time-based codes and time spent in medical consultation must be documented in the medical record. These codes do not differentiate between a new or established patient.