CDEO CPT Ch8.4 E&M Categories with Complete Solutions

There are 2 minimum requirements to bill for a consultation? - ANSWER-The minimal requirements to bill for a consultation are: 1. It must be requested by a physician or other appropriate source, 2. A written consultant report to the requesting provider of his opinion and any services performed or order made. If the consulted physician takes over the care of a patient, how should he bill subsequent visits? - ANSWER-If the consulting physician takes over the care of the patient he should bill subscript visits with the appropriate established patient visit codes, based on location. Since CMS does not reimburse for consultations, how should consulted providers bill for their services to Medicare? - ANSWER-Consulted providers for Medicare patients are advised to use the new and established office and outpatient codes or initial and subsequent hospital care coats in place of the consultation codes. What does CMS advise, if the consulted provider fails to document a minimum of a detailed history and exam for the initial inpatient encounter? - ANSWER-if the consult a provider fails to document a minimum of detailed history and exam for the initial impatient and counter, CMS advises the provider to code a subsequent hospital care code. FOR CERTIFICATION EXAM PURPOSES, How should consultation codes be used? - ANSWER-For certification exam purposes, select the EM category based on CPT coding guidelines, unless the case or the question on the exam states the patient is covered by Medicare. Do not assume based on the patient's age. Examinees are expected to know the CPT coding guidelines and the CMS coding guidelines for all certification exams.