by NAMAS
Mar 27th, 2020
The recent coronavirus crisis has brought non-face-to-face services to the forefront of coding and billing conversations. With the entire healthcare industry focused on caring for patients during an unprecedented and fast-moving pandemic, the goal of increasing patient access while reducing the risk of spreading infection has become paramount.
- The patient may be either a new or established patient to the consultant, but this service is not billable if consultant has seen the patient face-to-face within the last 14 days.
- When the online consultation leads to a transfer of care or other face-to-face service (e.g., a surgery, a hospital visit, or a scheduled office evaluation of the patient) within the next 14 days or next available appointment date of the consultant, these codes are not billable.
- Review of pertinent medical records, laboratory studies, imaging studies, medication profile, pathology specimens, etc. is included in this consultation and not reported separately. The majority of the service time reported (greater than 50%) must be devoted to the medical consultative verbal or Internet discussion. If greater than 50% of the time for the service is devoted to data review and/or analysis, report 99451, which is based on total review and discussion time rather than discussion time alone.
- Only one interprofessional consultation code is reportable within a seven-day interval.
- The written or verbal request for the consultation must be documented in the patient's medical record, including the reason for the request. Codes 99446, 99447, 99448, 99449 require a verbal opinion report and written report from the consultant to the requesting provider. Code 99451 requires only a written report.
- Interprofessional consultations of less than five minutes should not be reported.
- The treating/requesting provider may report 99452 if 16-30 minutes is spent preparing for the referral and/or communicating with the consultant. This code is billable once every 14 days.
- 99446: Interprofessional telephone/Internet/EHR assessment and management service provided by a consultative physician, including a verbal and written report to the patient's treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and review.
- 99447: 11-20 minutes of medical consultative discussion and review.
- 99448: 21-30 minutes of medical consultative discussion and review.
- 99449: 31 minutes or more of medical consultative discussion and review.
- 99451: Interprofessional telephone/Internet/EHR assessment and management service provided by a consultative physician, including a written report to the patient's treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time.
- 99452: Interprofessional telephone/Internet/EHR referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes.
References/Resources
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