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Wiki Consult E/M Code

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mlhosch

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Please help me with the proper use of the 99241-99245, Consult Codes. If a patient is coming from and Urgent Care to a Sports Med. Doctor, can the Sports Med. Doctor charge a consult code if the Urgent care states they are sending the pt. to Sports Med. in the documentation. I always thought it was a transfer of care from the Urg. Care to the specialist. But I have been told that if it is in the pt. chart at the Urg. Care it is ok to use the consult code.
 
No

A consult is a request from a provider to another provider for advice/opinion on how to manage a problem.

Urgent Care is transfering this patient to the specialist. Urgent Care doesn't want advice on how UC will treat the condition, they want the specialist to take over.

This would be a new (or possibly, existing) patient.

HOWEVER ... if UC asked the Sports Doctor to take a look at patient WHILE the patient was STILL at UC ... then it might be a consult.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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