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Thread: Physician Consultation

  1. #1

    Default Physician Consultation

    AAPC: Back to School
    One of my providers is going to sit down with a critically ill patient in our practice to discuss the patients needs, referrals etc. and fill out insurance forms for the patients insurance. This may take 45 min to an hour to do this she will not, however, be doing an exam on the patient during this time. Does anyone have any idea if there is a code we could use to bill the insurance?

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Counseling/Coordination of Care

    Read your CPT Guidelines on Counseling/Coordination of care.

    Physician must document ALL three of the following
    1) TOTAL face-to-face time spent with patient
    2) Amount of face-to-face time spent in counseling/coordination of care (must be at least 51% of total time)
    3) Summary of the counseling/coordination of care.

    For example: I spent 38 minutes with Mrs Patient today, discussing her prognosis, paliative measures and expected course of her disease process. All questions were answered and she expressed understanding. 100% of visit was spent in counseling/coordination of care.

    Then you will choose the level of E/M based on the TOTAL time spent.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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