A consultation is the provision of similar services to the same patient by more than one physician/QHP.

The Subsequent Hospital Care codes (99231-99233) are reported for subsequent observation care services.

The same definitions for critical care services apply for the adult, child, and neonate.

Code 99477 is reported for a neonate who requires intensive observation, frequent interventions, and other intensive care services.

Only one individual may report transitional care management services once per patient within seven days of discharge.

An interval history focuses on the period of time since the last time the patient was assessed.

For anticoagulation management services, any period less than 60 continuous outpatient days is not reported.

Is this encounter still considered a consultation? A patient is referred by his physician to see an orthopedic surgeon for a consultative service. During the first visit with the orthopedic surgeon, he or she initiates diagnostic or therapeutic service after completing the visit, opinion, or advice rendered back. Which code should be reported?

How is this procedure reported? A 20-year-old male was dropped off at the hospital emer- gency department with a knife hilt sticking out of his mid left anterior chest. The patient was not fully conscious. No one accompanied him. The patient was transported into the emergency department, and the attending emergency department physician began the evaluation. Physical examination was less than comprehensive. It was noted that whenever there was a peripheral pulse, the knife handle quivered. The attending emergency department physician initiated trauma team mobilization and ordered necessary diagnostics and fluid/ blood replacement products. A partial history was obtained and documented by the attending emergency department physician. Care of the patient proceeded under the attending emergency department physician's management. Twenty minutes after the patient was brought into the emergency department, the on-call trauma surgeon arrived in the emergency department, and the attending emergency department physician transferred care of the patient to the surgeon. The patient's need for a high-level E/M service and inability to provide a comprehensive history, as well as the unsuitability of an initial comprehensive examination, was evident in the medical record.

How is this service reported? A 69-year-old female established patient with atrial fibrillation who was taking long-term warfarin therapy to prevent systemic embolism came to see her physician for her initial 90 days of anticoagulant management. The physician and his staff accessed her medical record, reviewed the results, and determined whether any dosage adjustment and/or change in care plan were necessary. After this service, the physician made a dosage adjustment and care plan changes to account for acute illness and possible drug interactions, diet changes affecting vitamin K intake, and/or changes to procedures that required withholding or alternative anticoagulation. The physician then made a notation in the medical record, contacted the patient to convey the results/instructions, and arranged repeat testing at the appropriate interval.