Question

PCP sends a Medicare pt. to cardiologist for evaluation of complicated vascular problems during 1 hr. long encounter, specialist performs a comprehensive history & exam of NP, & follows up the visit w/ written repot to PCP; MDM was moderate

A) Office or Other Outpatient Consultation (99244)

B) Office or Other Outpatient Consultation (99215)

C) Office or Other Outpatient Consultation (99245)

D) Office or Other Outpatient Consultation (99213)

Answer 1

The appropriate CPT code for a Medicare patient's one-hour outpatient cardiologist consultation with comprehensive history, exam, and moderate medical decision making is 99244.

Step-by-step explanation:

The correct answer to the question is A) Office or Other Outpatient Consultation (99244). This CPT code is used for office or other outpatient consultations when the service provided includes a comprehensive history, a comprehensive examination, moderate complexity decision making, and the visit lasts typically 60 minutes face-to-face with the patient and/or family. In this case, the cardiologist provided a comprehensive history and examination for the new patient (NP), moderate medical decision making (MDM), and followed up with a written report to the primary care physician (PCP), indicating that code 99244 is the appropriate level of service.