tci Medicare Compliance & Reimbursement - 2021 Issue Q1

Reader Questions: Revisit Guidelines Before Billing These Consultation Codes

Question: Our physicians offered consultation services to a patient who was in treatment with another physician. How can we bill the consultation? Is it important that the consulting physician takes over the care of the patient? Illinois Subscriber Answer: You can report 99241-99245 (Office consultation for a new or established patient ...) if a physician takes over treatment of the condition; but, this does not assume a transfer of care. It is possible that a consultant may treat a patient and ultimately take over care for the condition the consultant has been asked to evaluate. You can think of...

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