Q&A: 2019 CPT codes for interprofessional consultations

January 4, 2019
Medicare Web

Q: What 2019 CPT updates were made to E/M codes for interprofessional telephone and internet consultations?

A: The American Medical Association (AMA) added two new codes and made four revisions to the “Interprofessional Telephone and Internet Consultations” subsection of the CPT Manual, which will become active January 1.

The updates impact coding for interprofessional consultations performed via communications technology. Interprofessional consultation codes (99446-99451) are reported by consulting providers who communicate with treating providers regarding a diagnosis or management of a patient’s problem. These services support a team-based approach to care and don’t include physician interaction with the patient.

CPT codes 99446-99449 were revised to include the assessment of electronic health records as part of the consultation service (emphasis added):

  • 99446, interprofessional telephone/internet/electronic health record 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 healthcare professional; 5-10 minutes of medical consultative discussion and review
  • 99447, …11-20 minutes
  • 99448, …21-30 minutes
  • 99449, …31 minutes or more

In the past, these services were bundled and not separately payable under Medicare. For 2019, Medicare is willing to recognize these as active codes that are separately reimbursable.

The AMA also introduced two new codes in this section:

  • 99451, interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient's treating/requesting physician or other qualified healthcare professional, 5 minutes or more of medical consultative time
  • 99452, interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified healthcare professional, 30 minutes

It should be noted that code 99451 doesn’t include any verbal interaction between practitioners. It can be accomplished with only a written report.

Code 99452 describes the services that the treating physician would spend in preparation for communication with a consulting physician. The treating physician must prepare for the interaction, so he or she uses the consultant’s time wisely.

It’s important for physicians to get the patient’s permission for these types of interprofessional consults because they will require a co-pay.

Editor’s note: Peggy Blue, MPH, CCS, CCS-P, CPC, CEMC, answered this question during HCPro’s webinar, “2019 CPT Update: Prepare for New Coding, Documentation Requirements.” This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

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