tci E/M Coding Alert - 2020 Issue Q4

You Be the Coder: Can You Clear up This Consultation Conundrum?

Question: Our provider examined a patient, then provided information about that patient’s condition to another provider on the same day. Is it possible to bill for the office and outpatient E/M and the consult on that day? And, if so, do I use 99451 or 99452 to report the consult? North Carolina Subscriber Answer: In this situation, if your provider is providing information about the patient to another provider who requested a consult from your provider, you would not use 99452 (Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional...

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