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Dr. Mark
Dr. Mark, Doctor (MD)
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Experience:  U.S. Physician/Surgeon in Neurosurgery
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An established patient is seen in the physicians office with

Customer Question

An established patient is seen in the physician's office with the chief complaint of a persistent cough. Otherwise, the patient claims to be in good health. THe physician collects a history, including the chief complaint and the history of the present illness. THe phsical exam performed focuses on the respiratory tract and evaluates patient for possible bronchitis (code?) the patient is sent to the clinic's radiology dept. for a two view chest xray study frontal and lateral (code?).. the radiologist send the xray results to the physician, who reviews them and orders a consultation with pumonologist from another clinic who in turn performs a comprehensive history and a comprehensive examination wth moderate complexity (code?). What are the correct CPT codes used for these procedures. More than one may apply to each?
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Mark replied 6 years ago.

This is tougher because there can be many codes for office visits:

 

99241 Office consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 15 minutes face-to-face with the patient and/or family.

 

This is probably appropriate for the first doctor since it was primarily focused on the lungs.

 

71020 Radiologic examination, chest, two views, frontal and lateral;

 

3006F Chest X-ray results documented and reviewed (CAP)

 

 

 

99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 45 minutes face-to-face with the patient and/or family.

 

This is probably appropriate for the specialist, given the fact it is "moderate complexity" and a comprehensive exam was done.

Customer: replied 6 years ago.

i need the CPT codes for these treatments.

established patient w/ possible case of bronchitis (code for office visit and diag. code for bronchitis)

 

radiology dept. code for the chest x-ray (71020)

 

radiologist (sep. charge for this dr.); with consultation to another doctor (pulmonologist) and the pulmonologist code for the examination.

 

This is for a coding class and I don't know how to find these codes on my own. I think that we have to code the three visits to three doctors with their charges for the tests.

Expert:  Dr. Mark replied 6 years ago.

I thing the office codes above are appropiate for the original doctor, and the specialist.

 

 

Here are some more codes:

 

76140 Consultation on x-ray examination made elsewhere, written report

 

Radiologists typically do not charge for "consultation" with another doctor, since that is usually assumed in the charge for their interpretation. The pulmonologist can call the radiologist to discuss the findings of the chest xray, but this is not a separate charge. The radiologist makes his money on interpretation of the 71020 code.

 

I'm not sure to what a "radiology department code" for the chest xray refers; every hospital department may have a different internal code for specific studies.

 

Customer: replied 6 years ago.
shouldn't there be a modifier code if more than one doctor met with this patient?
Expert:  Dr. Mark replied 6 years ago.

Hello-

 

There is another different answer coming from another expert that may help answer all your questions about these codes (as these are codes often seen by primary care physicians). Best of luck with your class.

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