Orthopedic Coding Alert

Question: If a patient is in the global period for an arthroscope by a physician in our practice, can we bill for a second opinion by another physician in our office due to continued pain and discomfort? The patient is not covered by Medicare.

Anonymous GA Subscriber

Answer: Consultations (99241-99255) provided by other physicians in the same practice are payable as long as all of the requirements of a consultation are met: documented request and need, the service is rendered as defined (the consulting physician must actually have an evaluation of the patient, not just a discussion of the case records with the requesting physician), and a written report of finds and recommendations is provided to the requesting physician.