Medical Coding

Category - Evaluation and Management

A physician has a mother who is concerned about her daughter having cancer. He does preliminary labs to help alleviate the mother’s fears, but some of the labs are coming back abnormal. He contacts the pediatric oncologist located more than an hour away by phone, requesting a telephone consultation regarding the abnormal labs and patient’s presentations. He spends 15 minutes on the phone consulting and obtaining recommendation for follow up labs and plan of care within his office. The oncologist does not believe this is related to cancer and has recommended additional work up. However, if subsequent labs are abnormal, he recommends follow up in his office. The subsequent labs are all within normal range and the primary physician repeats the labs again within his office in one month. What is the correct evaluation and management code for this consultation encounter?
  1. 99446
  2. 99447
  3. 99448
  4. 99449
Explanation
Answer: B - 99447 is the correct code for a consultation that lasts 15 minutes and that does not result in immediate transfer of care of other face-to-face service within the next 14 days.
Code 99446 is incorrect because this code is for consultation time between 5-10 minutes. Code 99448 is incorrect because this code is for consultation between 21-30 minutes. Code 99449 is incorrect because this consultation code is used for 31 minutes or more.
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