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Wiki CPT Coding for Chart Audits

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pwidner1

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I work for a Doc who specialty is pain management and is an addiction specialist and he would like to be able to do chart reviews, urine drug screening interpretation and psychological test reviews for primary care physicians' patients who are in pain to see if they would be in danger of becoming addicted to certain pain medications. He would not be seeing these patients in face to face visit but reviewing the charts and test results and giving his professional opinion as a specialist. Is there a CPT code that is payable by an insurance for something like this? I would appreciate any information and/ or links to help with my research into this matter for my doc. Thank you in advance. :confused:
 
Your provider will need to see the patient face to face in order to bill in a clinic setting. Medicare, Medicaid and I know that most payors require a face to face encounter to bill a CPT code. There are codes that are non-face to face driven, but they are typically following a previous E&M visit.

Only a pathologist can bill for a consult based on results of tests.

Check with your payors to see if they permit non-face to face encounter billing.
 
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