Wiki telehealth services~ physican to physician consultation

[tyrasma]

I am researching how a provider would bill for telephone consultation/care coordination without the member present. Here is an example of my situation:

A patient has an e/m visit with their primary care provider for chronic pain issues related to an underlying cause. Due to access issues, instead of the member being referred to a pain management specialist for an office consultation; the primary care provider has a phone conversation with the specialist discussing/developing a care coordination plan, including ordering and discussing test results in detail, discussing and evaluating new information and details or to initiate a new plan of care.

Because telemedicine and telehealth services are so new, I am having trouble finding guidance on coding this service. I understand that most care coordination services are bundled into the primary care providers e/m visit. However, in this situation I am looking for codes for the specialist to use for reimbursement for these services.

Does anyone have experience with this type of telehealth service or have any ideas on where to find documentation regarding physician to physician phone consultations?

Thanks,
Tina Potter, CPC

 

[btadlock1]

99358 + 99359 (if applicable). See the guidelines directly above those codes. (Prolonged Physician Service Without Direct (Face-to-Face) Patient Contact.

 

[btadlock1]

P.S.

A "medical team conference" consists of a minimum of 3 providers...you'll want to know that...