tci ED Coding & Reimbursement Alert - 2000 Issue 9

Reader Question: Consultation vs. Prolonged Service

Question: The doctor is called into the hospital to dilate a trachea site, small tube already in place, no cuff, needs cuff trachea tube to ventilate the patient. Is this a consult charge or prolonged service? He spent 45 minutes with the patient. Gwen CotteleseWyomissing, Pa. Answer: To meet the criteria for reporting consultations, the documentation must clearly indicate the referring physicians request for the consultation. After the consultation has taken place, a written report must be sent to the referring physician with the findings of the consultation. Codes 99241-99245 are used to bill for consultations performed in the...

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