Intraoperative Consults


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I have a vascular surgeon wanting to bill for a Intraoperative consult. He is under the impression that a intraoperative consult is automatically given a level 5 code. Also are there particular intraoperative consult codes or would it be billed using the regular 9924X, 9925X, or 9922X codes? Thanks in advance for your help.
Hard to Tell without documentation

It's hard to tell without the documentation ... HOWEVER ...

How can he justify a level 5 consultation if he could not get a full history or do a full exam on the patient (who, presumably, since this is intraoperative, is anesthesized and intubated).

I can't tell what the appropriate code is ... this might be an assist at surgery. It might be an intraoperative consult (i.e. your vascular surgeon ONLY gave advice to the primary surgeon on what was happening and how to deal with the issue(s) for which the consult was requested). If it truly was an intraoperative consult (and NOT an assist at surgery), then use the Unlisted E/M code 99499, and base your fee on the appropriate level of service, based on MDM alone.

Hope that helps.

F Tessa Bartels, CPC, CEMC