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LEVEL 1 OFFICE CONSULT
 

 

Level 1 Office Consult (99241)

This is the lowest level of care for an office consult.  Internists used this code for only 1.49% of these encounters in 2003.  To get an idea of the frequency of use of this code among sub-specialists, nephrologists used the 99241 for only 0.52% of consults performed in the office during that same year (which added up to only 833 visits in the entire country).  Usually the presenting problems are self-limited or minor.  The reimbursement for this level of care is approximately $49.00. 

Documentation requires THREE out of THREE of the following :

1)  Problem Focused History
2)  Problem Focused Exam
3)  Straightforward Medical Decision-Making

Or 15 minutes spent face-to-face with the patient if coding based on time.  The appropriate documentation must be included.

Clinical Example

This topic is covered in more detail in of one of our web-based E/M coding courses.
 

E/M Consult Services

Consult Services   Related Topics
 

 

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Although Medicare no longer pays for consult services, some private payers still do. But beware. Auditors love to downcode these visits when doctors don't include the exact right terminology. Learn to get it right.  
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