Wiki Using consult service

[jo.west]

I'm trying to find any information about the possibility for billing a virtual consult service with during an office visit with a pcp. If the practice were to use a type of virtual consult service subscription, and that service would provide a specialty consult during the office visit with the pcp, would there be any way to recoup the cost of the consult service.

What the clinicians are asking is, if the virtual consult happens on the same date of service (before, during or after the office visit) would that change the level of service. My thinking is that if it's on the date of service, since e/m guidelines state all f2f and non f2f activities count, then it's possible it could affect the mdm. But I'm looking for something concrete.

Does anyone have experience with this type of scenario?

 

[SDargaj]

Guidelines do not state that ALL f2f & non f2f activities count. If you are leveling based on time, there are certain f2f & non f2f activities that you can count, and others that you cannot count.
This concept would not be applicable if leveling based off of MDM.

 

[jo.west]

Guidelines do not state that ALL f2f & non f2f activities count. If you are leveling based on time, there are certain f2f & non f2f activities that you can count, and others that you cannot count.
This concept would not be applicable if leveling based off of MDM.

Thanks for your reply.

I hear what you're saying about all f2f and non f2f activities. For leveling based on time, and after revisiting the guidelines, I agree with you.

And for leveling based on MDM, I'm wondering if the amount and/or complexity of data to be reviewed or analyzed at an encounter would apply. According to the guidelines, External: External records, communications and/or test results are from an external physician, other qualified health care professional, facility, or health care organization.
External physician or other qualified health care professional: An external physician or other qualified health care professional who is not in the same group practice or is of a different specialty or subspecialty. This includes licensed professionals who are practicing independently. The individual may also be a facility or organizational provider such as from a hospital, nursing facility, or home health care agency.
Discussion: Discussion requires an interactive exchange. The exchange must be direct and not through intermediaries (eg, clinical staff or trainees). Sending chart notes or written exchanges that are within progress notes does not qualify as an interactive exchange. The discussion does not need to be on the date of the encounter, but it is counted only once and only when it is used in the decision making of the encounter. It may be asynchronous (ie, does not need to be in person), but it must be initiated and completed within a short time period (eg, within a day or two).

This sounds like it would apply to the data section of the MDM table.