decisionhealth Newsletters, Coder Pink Sheets - 2007 Issue 11 (November)
Don't recode consultations as office visits
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Article Overview
This article is for pediatricians, primary care clinicians, and coding staff who need to understand how consultation reporting differs from office visit reporting. It discusses consultation eligibility, the importance of a requesting physician and written report, and general time-based evaluation and management documentation guidance.
Why This Topic Matters
Properly recognizing consultation services can affect whether a claim is reported at a lower office-visit level or a higher consultation level. The article also highlights documentation elements that support reporting and help avoid undercoding.
Article Sections
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Don’t recode consultations as office visits
Introduces the topic of consultation reporting versus office visit reporting in outpatient coding, with emphasis on pediatric and primary care settings.
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How to select time-based E/M levels
Summarizes general time-based evaluation and management documentation concepts, including the role of total visit time and timing details in recordkeeping.
What You Will Learn
- How consultation reporting differs from office visit reporting in general
- What documentation elements are discussed for supporting consultation services
- How time-based evaluation and management coding is described at a high level
- Why timing details may be helpful in documentation
Who Should Read This
- Pediatricians
- Primary care physicians
- Medical coders
- Billing staff
- Practice managers
Codes Discussed
Code Ranges Discussed
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