tci General Surgery Coding Alert - 2002 Issue 10

Reader Question: Time-Based Consult

Question: Our surgeon spent 85 minutes providing a consultation for a patient in the hospital. He performed a minimal evaluation, but most of the visit was spent reviewing an MRI, discussing the results and counseling the patient. In this case, does time supersede all other elements of E/M coding? Would 99255 be appropriate? Colorado SubscriberAnswer: CPT guidelines for 99255 (Initial inpatient consultation for a new or established patient ...) require a comprehensive history, examination and medical decision-making of high complexity. In this case, these requirements have not been met. However, a consult may be billed with time as the...

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