AMA CPT® Assistant - 2012 Issue 11 (November)
Evaluation and Management (Q&A) (November 2012)
November 2012 page 12 Evaluation and Management Question: Is it appropriate to report the online E/M CPT code 99444 for the following situation? A new patient (not previously seen by this or any other physician of the same specialty or group practice) contacts the physician service via an Internet inquiry for a second opinion regarding a medical condition. The physician reviews the history (provided by an electronic upload of the patient chart) and the patient's concerns and questions, and then provides an electronic opinion to the patient with the understanding that this is an online second opinion and is...
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Article Overview
This article is a brief evaluation and management Q&A from November 2012 focused on an online second-opinion scenario and the related CPT reporting considerations. It is relevant to coders, billers, auditors, and clinical practices that handle electronic patient communications and unlisted E/M reporting. The article also notes the role of documentation and distinguishes CPT guidance from payer-specific policy.
Why This Topic Matters
It helps readers understand how a specific electronic consultation scenario fits within CPT evaluation and management reporting and when additional documentation may be needed for an unlisted service.
Article Sections
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Evaluation and Management
A question-and-answer discussion of an electronic patient interaction and the related evaluation and management reporting context. The section focuses on CPT guidance, established-patient considerations, and documentation for an unlisted service.
What You Will Learn
- How a specific online evaluation and management scenario is addressed in a CPT Q&A format
- What types of general reporting considerations are discussed for electronic physician-patient communications
- Why documentation may be relevant when an unlisted evaluation and management service is considered
- How payer policy differences are acknowledged in relation to CPT guidance
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Auditors
- Physician practices
- Revenue cycle professionals
Codes Discussed
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