Pulmonology Coding Alert

Question: What is the appropriate E/M code for a pulmonary consultation with pre- and post-bronchodilator spirometry when a military academy (instead of a physician) has requested it? The pulmonologist in my practice saw a 17-year-old patient applying for the academy; the patient has a history of acute bronchitis, but had no current respiratory-related concerns. The exam turned out normal while the pre-and post-bronchodilator spirometry was normal with no obstruction and no bronchodilator responsiveness. Nebraska Subscriber Answer: You should bill new patient visit code 99201-99205 provided the patient is not established to the practice (seen by a physician in the practice within the last three years). This would not constitute a consultation service since only healthcare providers involved in the patient's care can request a consultation. School personnel cannot request a consultation as an entrance requirement. Additionally, the service is typically paid for by the patient himself or the military academy, [...]