Interprofessional consult (99446-99451) once every 7 days

SUEV

Guru
Local Chapter Officer
Messages
206
Best answers
0
When a provider is asked to review records twice on the same patient within 7 days, is there any way to charge for the second service? For example:

*On day one the consultant discusses the case with the requesting provider and completes her report. This takes 40 minutes and she charges 99449.
*On day five the patient's condition deteriorates so the consultant is again asked to review records and discusses it with the requesting provider and completes her report. Per CPT, 99446-99449 can only be reported once in a seven-day interval. Does this new
request start the clock over or is this service included in the initial consult?

Thank you,
Sue
 
Messages
4
Location
Evans, GA
Best answers
0
A provider that is not part of your group has nothing to do with your coding/billing in this case.
So, if I bill/code for both providers, and they're in the same billing area ie. same specialty within the hospital, it doesn't matter? I cannot use that code twice within 7 days, period? What if they were in different billing areas ie. dermatology, cardiology?
 

SharonCollachi

True Blue
Messages
1,980
Location
Clovis, CA
Best answers
3
Do they work for the same company? If they don't work for the same company, they are each free to provide those services and bill for them.
 
Messages
4
Location
Evans, GA
Best answers
0
Yes, same company, same specialty. Do you know where I can find the guidelines, besides the CPT manual about this?
I'm really confused if the doctors are from different specialties, they should be able to bill within a 7 day interval, because they're treating different things, right?
 
Top