Wiki interprofessional services in ER

[bevlewis07]

Hello,

I will like to know what codes can be used for services performed over the phone as interprofessional. My provider is asked to consult a patient regarding possible stroke this is done via audio. right now he would like to use 99441 but this is for established patients etc. I found 99451 and 99446, but as I continue to research we will need the patient or family consent. Please advise what can be used. The documentation states the requesting provider name, what documents were reviewed and his assessment.

 

[Pam Warren]

Interprofessional consultations require that a requesting provider, who informs the consultant of the patient's condition, gets verbal (per the Final Rule) consent from the patient (or family) for the charge your provider will incur without them having seen the patient, and obtains the resulting opinion of the consultant. The consultant must provide a written report to the referring provider as well. The difference between 99446 and 99451 is that 99446 includes the consultant's records review and discussion between both providers, and 99451 is simply discussion time alone. These are all time-based codes (99446-99452) so time must be documented in the note. If care is transferred to the consultant within 2 weeks, or if the patient saw the consultant in the last 2 weeks, these codes can't be billed.