Make sure practitioners get credit for requesting a virtual consult

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This piece is aimed at primary care and other treating practitioners who coordinate care with specialists through phone, email, or electronic records. It discusses general reporting considerations for interprofessional referral services, how timing can affect reporting when work is performed on a different day than an office visit, and the relationship between these services and prolonged service reporting.

Why This Topic Matters

Practices that routinely coordinate complex patient care need to know when referral-related work may be reported separately so practitioner effort is recognized accurately and billing is handled consistently.

Article Sections

  1. Question

    A family practice group describes time spent coordinating with specialists for complex patients and asks whether credit is available when the request is made on a different day than the office visit.

  2. Answer

    The article discusses the general reporting approach for interprofessional referral services and notes timing considerations, frequency limitations, and the interaction with office visit reporting.

  3. Prolonged service codes allowed

    This section addresses broader prolonged service reporting concepts that may apply when the time involved extends beyond a typical evaluation and management service.

What You Will Learn

  • How interprofessional referral-related work is discussed in the context of practitioner reporting
  • What general timing considerations affect whether related work may be reported separately
  • How prolonged service concepts relate to referral-related communication time
  • Which broad situations involve phone, email, or electronic record communication with consultants

Who Should Read This

  • Family medicine practices
  • Treating physicians
  • Nurse practitioners
  • Primary care billing staff
  • Coding and compliance staff

Codes Discussed

Code Ranges Discussed


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