RE: CPT for kidney transplant evaluation services?

[Guest guest]

99255(inpatient)

99215(outpatient)

Kelbe

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH Trnsplnt

Sent: Thursday, November 20, 2008

2:20 PM

To:

TxFinancialCoordinators

Subject:

CPT for kidney transplant evaluation services?

hi everyone,

what CPT do you use when a payer wants one on your request for

authorization for transplant evaluation services? thanks for any help

on

Financial Counselor

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorrisolhs (DOT) org

kidney transplant evaluation

services

[Guest guest]

We use 99245 for Out-patient Evaluations.

Thank You,

Beverly mailto:Bmitchell@...

UCLA Transplant Financial Coordinator

Telephone#

Fax #

PLEASE NOTE: This e-mail (and any attachments) is only intended for the use of the person or entity to which it is addressed and contains information that is privileged and confidential. You, the recipient, are obligated

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or return email and delete this message from your computer.

CPT for kidney transplant evaluation services?

hi everyone, what CPT do you use when a payer wants one on your request for authorization for transplant evaluation services?

thanks for any help

on

Financial Counselor

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorrisolhs (DOT) org

kidney transplant evaluation services

IMPORTANT WARNING: This email (and any attachments) is only intended for the use of the person or entity to which it is addressed, and may contain information that is privileged and confidential. You, the recipient,

are obligated to maintain it in a safe, secure and confidential manner. Unauthorized redisclosure or failure to maintain confidentiality may subject you to federal and state penalties. If you are not the intended recipient, please immediately notify us by

return email, and delete this message from your computer.

[Guest guest]

99245, and all other clinical testing codes (i.e. chest x-ray, ultrasound and so on)

,

Transplant Financial Coordinator

Division of Transplantation

University of California Irvine Medical Center

333 City Blvd West, Suite 1205, Rte 190

Orange, CA 92868

phone

fax

page

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Thursday, November 20, 2008 11:20 AM

To: TxFinancialCoordinators

Subject: CPT for kidney transplant evaluation services?

hi everyone, what CPT do you use when a payer wants one on your request for authorization for transplant evaluation services? thanks for any help

on

Financial Counselor

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorrisolhs (DOT) org

kidney transplant evaluation services

This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately

by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. E-mail transmission cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, arrive late or incomplete, or

contain viruses. The sender therefore does not accept liability for any errors or omissions in the contents of this message, which arise as a result of e-mail transmission.

[Guest guest]

Both 99215 and 99245 are E & M CPT codes

(evaluation and management) – with different levels of service. As 99245

is the more complex, might use that when request authorization for transplant

even if the MD & facility only eventually bills for 99215. Any billing

audit would look to see if the office note included the components noted.

99245

Office consultation for a new or established patient, which

requires these 3 key components: A comprehensive history; A comprehensive

examination; and Medical decision making of high 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 80 minutes face-to-face with the patient and/or family.

99215

Office or other outpatient visit for the evaluation and

management of an established patient, which requires at least 2 of these 3 key

components: A comprehensive history; A comprehensive examination; Medical

decision making of high 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 40

minutes face-to-face with the patient and/or family

And yes, then the separate CPT codes for

the labs, chest x-ray, EKG, ultrasound, etc etc.

Daryl Battin,

LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

Page:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of ,

Sent: Thursday, November 20, 2008

2:49 PM

To: TxFinancialCoordinators

Subject: RE:

CPT for kidney transplant evaluation services?

99245, and all other clinical testing

codes (i.e. chest x-ray, ultrasound and so on)

, Transplant Financial Coordinator

Division of Transplantation

University of California Irvine Medical Center

333 City Blvd West, Suite 1205, Rte 190

Orange, CA 92868

phone fax page

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH

Trnsplnt

Sent: Thursday, November 20, 2008

11:20 AM

To: TxFinancialCoordinators

Subject:

CPT for kidney transplant evaluation services?

hi everyone,

what CPT do you use when a payer wants one on your request for

authorization for transplant evaluation services? thanks for any help

on

Financial Counselor

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorrisolhs (DOT) org

kidney transplant evaluation

services

This message contains confidential

information and is intended only for the individual named. If you are not the

named addressee you should not disseminate, distribute or copy this e-mail.

Please notify the sender immediately by e-mail if you have received this e-mail

by mistake and delete this e-mail from your system. E-mail transmission cannot

be guaranteed to be secure or error-free as information could be intercepted,

corrupted, lost, destroyed, arrive late or incomplete, or contain viruses. The

sender therefore does not accept liability for any errors or omissions in the

contents of this message, which arise as a result of e-mail transmission.

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

thanks everyone!

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Battin, Daryl J.Sent: Thursday, November 20, 2008 1:56 PMTo: TxFinancialCoordinators Subject: RE: CPT for kidney transplant evaluation services?

Both 99215 and 99245 are E & M CPT codes (evaluation and management) – with different levels of service. As 99245 is the more complex, might use that when request authorization for transplant even if the MD & facility only eventually bills for 99215. Any billing audit would look to see if the office note included the components noted.

99245

Office consultation for a new or established patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high 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 80 minutes face-to-face with the patient and/or family.

99215

Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high 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 40 minutes face-to-face with the patient and/or family

And yes, then the separate CPT codes for the labs, chest x-ray, EKG, ultrasound, etc etc.

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

Page:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of , Sent: Thursday, November 20, 2008 2:49 PMTo: TxFinancialCoordinators Subject: RE: CPT for kidney transplant evaluation services?

99245, and all other clinical testing codes (i.e. chest x-ray, ultrasound and so on)

, Transplant Financial Coordinator Division of Transplantation University of California Irvine Medical Center 333 City Blvd West, Suite 1205, Rte 190 Orange, CA 92868 phone fax page

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Thursday, November 20, 2008 11:20 AMTo: TxFinancialCoordinators Subject: CPT for kidney transplant evaluation services?

hi everyone, what CPT do you use when a payer wants one on your request for authorization for transplant evaluation services? thanks for any help

on Financial Counselor Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorrisolhs (DOT) org

kidney transplant evaluation services

This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. E-mail transmission cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, arrive late or incomplete, or contain viruses. The sender therefore does not accept liability for any errors or omissions in the contents of this message, which arise as a result of e-mail transmission.

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.