CPT® 2014 Introduces 4 New Consultation Codes

Interestingly, four new codes have been added that describe the work of two medical professionals who discuss a patient’s condition over phone or Internet.

A few years ago, Medicare and other carriers stopped recognizing consultation codes. But all that is about to change as CPT® 2014 has added four new consultation codes with effect from January 1, 2014.
So from the first day of the New Year, if two medical professionals discuss a patient’s condition via phone or internet, you’ll report the following codes:

• 99446 – Interprofessional telephone/Internet assessment and management service provided by a consultative physician including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and review
• 99447 – … 11-20 minutes of medical consultative discussion and review
• 99448 – … 21-30 minutes of medical consultative discussion and review
• 99449 – … 31 minutes or more of medical consultative discussion and review.

These codes are more likely to be used for complex or urgent cases where the situation makes it difficult for the consultation to provide a face-to-face service, reads CPT® 2014 guidelines. For example, the consultant may be located far away.
Questions related to time
Coders need to be alert to:

• Why these codes are broken into time
• How that time will be measured (reading, discussing, interpreting, further research, etc.).
• How will the time be documented
• Will it be documented

Tips you’d like to make note of:

• For consultations less than 5 minutes, avoid using these codes
• Major part of the service time reported (more than half) must be devoted to the medical consultative verbal/Internet discussion.
  • The consult includes review of related medical records, path/lab studies, imaging, medications, and similar date.
  • A single code covers all contact time and review time, so add together and calculate the total time spent when multiple calls/internet contacts are performed for a single consult.

The earlier you’re up to speed on the 2014 CPT^® changes, such as the above-mentioned new codes for inter-professional consultations, the more likely for you to see fewer payment delays for those services.