Interproffessional Telephone consults, HELP :/

[KoBee]

A bit confused if anyone is willing to help out understand when to be able to use 99446-99452

Our provider is looking to be able to bill for these specific services and I want to make sure i'm reading the guidelines correctly.. if just transfer of care, these aren't the codes? or which codes should be used for issues below?

1. Admitted to ICU from tele (new icu consult):
2. 2. Seen by the group in ER for consult, admitted to tele before MN but Rapid response was called around 0200 and have to transfer to ICU
3. Pulmonary consult for a patient on tele 4. Any patient’s who are admitted to ICU 5. Follow up CPT code on pt’s in ICU; tele;med surg
   
   

 

[jkyles]

I'd need a bit more detail to answer about specific instances but a key thing to consider are the 14 day windows for face-to-face encounters associated with the codes:

The patient for whom the interprofessional telephone/Internet/electronic health record consultation is requested may be either a new patient to the consultant or an established patient with a new problem or an exacerbation of an existing problem. However, the consultant should not have seen the patient in a face-to-face encounter within the last 14 days. When the telephone/Internet/electronic health record consultation leads to a transfer of care or other face-to-face service (eg, a surgery, a hospital visit, or a scheduled office evaluation of the patient) within the next 14 days or next available appointment date of the consultant, these codes are not reported.

In addition, you can't bill the codes if the sole purpose of the communication is to arrange a face-to-face service or transfer of care.

Keep in mind that the codes are time-based.