However, not all payers will pay for consultations, Medicare chief among them. If this is the case for this patient, was the patient ever seen by one of your cardiologists within the last three years? If so, because the patient was treated a physician of the same speciality within the same group in those three years, you would need to use the established office/outpatient visit code, 99212-99215. If the patient does not fit this definition of an established patient, then you would use 99201-99205 as appropriate for a new patient office/outpatient visit.
Hopefully this helps you. Keep the questions coming if you need more help.
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