Neurology & Pain Management Coding Alert

READER QUESTIONS:

No Consult Charge for Transfer of Care

Question: A patient was seen in the emergency room for neck pain. The ER doctor asked my neurologist to see the patient for an -eval and treat- in our office on the same day. How should I code this? Georgia Subscriber Answer: If your neurologist has not had a face-to-face service with this patient within the past three years, this would be a new-patient encounter with transfer of care as far as your coding is concerned. Choose a new-patient E/M code (99201-99205, Office or other outpatient visit for the evaluation and management of a new patient,which requires these 3 key components ...). If the patient is already a patient of your neurologist, then use the appropriate established-patient code (99211-99215). There is most likely no consultation E/M service for this scenario -- the ER physician is not asking for your neurologist's opinion but rather is transferring care of the patient's condition.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Neurology & Pain Management Coding Alert

View All