A patient visits the office of an ear, nose, and throat (ENT) specialist and tells the office staff that a general practitioner referred him to a specialist for an ongoing problem with sinusitis. The ENT office has not received an oral or written request from the general practitioners office. Can this patient visit be reported as a consultation ( 99241 [REVISED IN 2013]- 99245 ) based upon the patients statement? ...
Subscribe or sign in to view the full article.
Article Overview
This premium article addresses consultation reporting in an ENT setting when a patient reports being referred for a sinusitis-related problem but the specialist office has not received a formal request. It is aimed at coders, billers, and clinical staff who need to distinguish consultation services from other evaluation and management services and understand the documentation elements discussed in the article.
Why This Topic Matters
Correctly identifying whether an encounter qualifies as a consultation affects evaluation and management reporting and helps avoid inappropriate use of consultation code ranges when the required request and documentation are not present.
What You Will Learn
- How consultation reporting is distinguished from other evaluation and management services.
- What types of communication and documentation are discussed in relation to a consultation request.
- Which broad encounter categories may be considered when a consultation is not supported.
- How the article frames referrals initiated by a patient versus those requested by another source.
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- ENT office staff
- Clinical documentation staff
Codes Discussed
Code Ranges Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com