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RE: [CRN-L] Intra-operative consultation

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  • Hvizdash, Suzan
    Because the PFSH and the ROS can be captured by anyone, this information can be conveyed by the referring physician, the chart, the nurse, etc. The HPI would
    Message 1 of 12 , May 2 8:18 AM
      Because the PFSH and the ROS can be captured by anyone, this information can
      be conveyed by the referring physician, the chart, the nurse, etc. The HPI
      would be of a limited nature, because of the current state of the patient.
      However, that too should be documented. The physical and the MDM can be
      done. The coding would then be based on the required elements.

      Suzan

      > -----Original Message-----
      > From: mrivera@... [SMTP:mrivera@...]
      > Sent: Friday, May 02, 2003 10:59 AM
      > To: CRN-L@yahoogroups.com
      > Subject: RE: [CRN-L] Intra-operative consultation
      >
      > I don't think you can. The elements that comprise an E&M consultation are
      > not there: ROS? actual physical exam? PFSH?
      >
      > -----Original Message-----
      > From: Karen Pyrz [mailto:kpyrz@...]
      > Sent: Friday, May 02, 2003 9:32 AM
      > To: CRN-L@yahoogroups.com
      > Subject: Re: [CRN-L] Intra-operative consultation
      >
      >
      > I'm trying again, no one responded yesterday.... ANY help is
      > appreciated.
      >
      >
      >
      > >>> kpyrz@... 05/01/03 03:41PM >>>
      > I am interested in learning how anyone is coding an intra-operative
      > consultation. If the surgeon is requested to come into the
      > operating room (actually scrubs and spends at least 1 hour) to render
      > his opinion, he may not acutally perform any part of the operation,
      > can we code an inpatient consultation? Any and all opinions are
      > appreciated.
      >
      > Thank you
      > Karen
      >
      >
      >
      > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
      > CLICK ME LINKS:
      > Coding Certification & CEU TeleCourseTM Training & Videos
      > http://www.crn-institute.com
      > E&M Training Videos
      > http://www.mhcconsulting.com/
      > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
      > CRN Homepage:
      > http://www.codingandreimbursement.net
      > Become a CRN Gold Member!
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      >
      >
      > [Non-text portions of this message have been removed]
      >
      >
      > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
      > CLICK ME LINKS:
      > Coding Certification & CEU TeleCourseTM Training & Videos
      > http://www.crn-institute.com
      > E&M Training Videos
      > http://www.mhcconsulting.com/
      > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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      >
      > The information contained in this electronic e-mail transmission
      > and any attachments are intended only for the use of the individual
      > or entity to whom or to which it is addressed, and may contain
      > information that is privileged, confidential and exempt from
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      > is not the intended recipient, or the employee or agent responsible
      > for delivering this communication to the intended recipient, you
      > are hereby notified that any dissemination, distribution, copying
      > or disclosure of this communication and any attachment is strictly
      > prohibited. If you have received this transmission in error, please
      > notify the sender immediately by telephone and electronic mail,
      > and delete the original communication and any attachment from any
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      > not a waiver of any attorney-client, physician-patient or other
      > privilege. Thank you.
      >
      > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
      > CLICK ME LINKS:
      > Coding Certification & CEU TeleCourseTM Training & Videos
      > http://www.crn-institute.com
      > E&M Training Videos
      > http://www.mhcconsulting.com/
      > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
      > CRN Homepage:
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      > Become a CRN Gold Member!
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      [Non-text portions of this message have been removed]
    • Barbara Cobuzzi
      You can also state that you could not get the HPI from patient because they were unconscious, that is ok and counts as complete. Barbara Barbara J. Cobuzzi,
      Message 2 of 12 , May 2 8:20 AM
        You can also state that you could not get the HPI from patient because
        they were unconscious, that is ok and counts as complete.

        Barbara

        Barbara J. Cobuzzi, MBA, CPC, CPC-H, CHBME
        President, Cash Flow Solutions, Inc. Lakewood, NJ
        VP, Coding and Reimbursement Network
        Networker of the Year for the American Academy of Professional Coders
        1999
        Member of the National Advisory Board, American Academy of Professional
        Coders
        (732) 364-0123 x200 Voice (732) 364-9111 Fax
        ___________________________________________ 

        Attention! This electronic message contains information that may be
        legally confidential and/or privileged. The information is intended
        solely for the individual or entity named above and access by anyone
        else is unauthorized. If you are not the intended recipient, any
        disclosure, copying, distribution, or use of the contents of this
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        sender that you have received the message in error, and delete it.
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        -----Original Message-----
        From: Hvizdash, Suzan [mailto:hvizdashsh@...]
        Sent: Friday, May 02, 2003 11:19 AM
        To: 'CRN-L@yahoogroups.com'
        Subject: RE: [CRN-L] Intra-operative consultation

        Because the PFSH and the ROS can be captured by anyone, this information
        can
        be conveyed by the referring physician, the chart, the nurse, etc. The
        HPI
        would be of a limited nature, because of the current state of the
        patient.
        However, that too should be documented. The physical and the MDM can be
        done. The coding would then be based on the required elements.

        Suzan

        > -----Original Message-----
        > From: mrivera@... [SMTP:mrivera@...]
        > Sent: Friday, May 02, 2003 10:59 AM
        > To: CRN-L@yahoogroups.com
        > Subject: RE: [CRN-L] Intra-operative consultation
        >
        > I don't think you can. The elements that comprise an E&M consultation
        are
        > not there: ROS? actual physical exam? PFSH?
        >
        > -----Original Message-----
        > From: Karen Pyrz [mailto:kpyrz@...]
        > Sent: Friday, May 02, 2003 9:32 AM
        > To: CRN-L@yahoogroups.com
        > Subject: Re: [CRN-L] Intra-operative consultation
        >
        >
        > I'm trying again, no one responded yesterday.... ANY help is
        > appreciated.
        >
        >
        >
        > >>> kpyrz@... 05/01/03 03:41PM >>>
        > I am interested in learning how anyone is coding an intra-operative
        > consultation. If the surgeon is requested to come into the
        > operating room (actually scrubs and spends at least 1 hour) to render
        > his opinion, he may not acutally perform any part of the operation,
        > can we code an inpatient consultation? Any and all opinions are
        > appreciated.
        >
        > Thank you
        > Karen
        >
        >
        >
        > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        > CLICK ME LINKS:
        > Coding Certification & CEU TeleCourseTM Training & Videos
        > http://www.crn-institute.com
        > E&M Training Videos
        > http://www.mhcconsulting.com/
        > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        > CRN Homepage:
        > http://www.codingandreimbursement.net
        > Become a CRN Gold Member!
        > http://www.codingandreimbursement.net/GoGold.htm
        > Advertiser Options
        > http://www.codingandreimbursement.net/adverting.htm
        > Change your subscription settings (i.e.. digest or vacation mode)
        > http://groups.yahoo.com/group/crn-l/join
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        > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        >
        >
        > Your use of Yahoo! Groups is subject to
        http://docs.yahoo.com/info/terms/
        >
        >
        > [Non-text portions of this message have been removed]
        >
        >
        > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        > CLICK ME LINKS:
        > Coding Certification & CEU TeleCourseTM Training & Videos
        > http://www.crn-institute.com
        > E&M Training Videos
        > http://www.mhcconsulting.com/
        > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        > CRN Homepage:
        > http://www.codingandreimbursement.net
        > Become a CRN Gold Member!
        > http://www.codingandreimbursement.net/GoGold.htm
        > Advertiser Options
        > http://www.codingandreimbursement.net/adverting.htm
        > Change your subscription settings (i.e.. digest or vacation mode)
        > http://groups.yahoo.com/group/crn-l/join
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        > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        >
        >
        > Your use of Yahoo! Groups is subject to
        http://docs.yahoo.com/info/terms/
        >
        > _____________________________________________________________________
        >
        > The information contained in this electronic e-mail transmission
        > and any attachments are intended only for the use of the individual
        > or entity to whom or to which it is addressed, and may contain
        > information that is privileged, confidential and exempt from
        > disclosure under applicable law. If the reader of this communication
        > is not the intended recipient, or the employee or agent responsible
        > for delivering this communication to the intended recipient, you
        > are hereby notified that any dissemination, distribution, copying
        > or disclosure of this communication and any attachment is strictly
        > prohibited. If you have received this transmission in error, please
        > notify the sender immediately by telephone and electronic mail,
        > and delete the original communication and any attachment from any
        > computer, server or other electronic recording or storage device
        > or medium. Receipt by anyone other than the intended recipient is
        > not a waiver of any attorney-client, physician-patient or other
        > privilege. Thank you.
        >
        > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        > CLICK ME LINKS:
        > Coding Certification & CEU TeleCourseTM Training & Videos
        > http://www.crn-institute.com
        > E&M Training Videos
        > http://www.mhcconsulting.com/
        > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        > CRN Homepage:
        > http://www.codingandreimbursement.net
        > Become a CRN Gold Member!
        > http://www.codingandreimbursement.net/GoGold.htm
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        >


        [Non-text portions of this message have been removed]


        ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        CLICK ME LINKS:
        Coding Certification & CEU TeleCourseTM Training & Videos
        http://www.crn-institute.com
        E&M Training Videos
        http://www.mhcconsulting.com/
        ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        CRN Homepage:
        http://www.codingandreimbursement.net
        Become a CRN Gold Member!
        http://www.codingandreimbursement.net/GoGold.htm
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      • mrivera@nshs.edu
        Thanks for the info!! ... From: Barbara Cobuzzi [mailto:b.cobuzzi@att.net] Sent: Friday, May 02, 2003 10:59 AM To: CRN-L@yahoogroups.com Subject: RE: [CRN-L]
        Message 3 of 12 , May 2 8:25 AM
          Thanks for the info!!

          -----Original Message-----
          From: Barbara Cobuzzi [mailto:b.cobuzzi@...]
          Sent: Friday, May 02, 2003 10:59 AM
          To: CRN-L@yahoogroups.com
          Subject: RE: [CRN-L] Intra-operative consultation


          You don't need a history. There is the caveat that you don't need to get
          a history is the patient is unable to give you one. A patient under
          general anesthesia cannot give you one. You can document the related
          history from the requesting physician, though. And you are examining
          the open patient and you are doing high level MDM. It has always
          counted as a consult when being called to do an interoperative
          consultation. But doctor must document document and then some more as
          has already been indicated.

          Barbara

          Barbara J. Cobuzzi, MBA, CPC, CPC-H, CHBME
          President, Cash Flow Solutions, Inc. Lakewood, NJ
          VP, Coding and Reimbursement Network
          Networker of the Year for the American Academy of Professional Coders
          1999
          Member of the National Advisory Board, American Academy of Professional
          Coders
          (732) 364-0123 x200 Voice (732) 364-9111 Fax
          ___________________________________________ 

          Attention! This electronic message contains information that may be
          legally confidential and/or privileged. The information is intended
          solely for the individual or entity named above and access by anyone
          else is unauthorized. If you are not the intended recipient, any
          disclosure, copying, distribution, or use of the contents of this
          information is prohibited and may be unlawful. If you have received
          this electronic transmission in error, please reply immediately to the
          sender that you have received the message in error, and delete it.
          Release/Disclosure Statement


          -----Original Message-----
          From: mrivera@... [mailto:mrivera@...]
          Sent: Friday, May 02, 2003 10:59 AM
          To: CRN-L@yahoogroups.com
          Subject: RE: [CRN-L] Intra-operative consultation

          I don't think you can. The elements that comprise an E&M consultation
          are
          not there: ROS? actual physical exam? PFSH?

          -----Original Message-----
          From: Karen Pyrz [mailto:kpyrz@...]
          Sent: Friday, May 02, 2003 9:32 AM
          To: CRN-L@yahoogroups.com
          Subject: Re: [CRN-L] Intra-operative consultation


          I'm trying again, no one responded yesterday.... ANY help is
          appreciated.



          >>> kpyrz@... 05/01/03 03:41PM >>>
          I am interested in learning how anyone is coding an intra-operative
          consultation. If the surgeon is requested to come into the
          operating room (actually scrubs and spends at least 1 hour) to render
          his opinion, he may not acutally perform any part of the operation,
          can we code an inpatient consultation? Any and all opinions are
          appreciated.

          Thank you
          Karen



          ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
          CLICK ME LINKS:
          Coding Certification & CEU TeleCourseTM Training & Videos
          http://www.crn-institute.com
          E&M Training Videos
          http://www.mhcconsulting.com/
          ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
          CRN Homepage:
          http://www.codingandreimbursement.net
          Become a CRN Gold Member!
          http://www.codingandreimbursement.net/GoGold.htm
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          [Non-text portions of this message have been removed]


          ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
          CLICK ME LINKS:
          Coding Certification & CEU TeleCourseTM Training & Videos
          http://www.crn-institute.com
          E&M Training Videos
          http://www.mhcconsulting.com/
          ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
          CRN Homepage:
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          Become a CRN Gold Member!
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          _____________________________________________________________________

          The information contained in this electronic e-mail transmission
          and any attachments are intended only for the use of the individual
          or entity to whom or to which it is addressed, and may contain
          information that is privileged, confidential and exempt from
          disclosure under applicable law. If the reader of this communication
          is not the intended recipient, or the employee or agent responsible
          for delivering this communication to the intended recipient, you
          are hereby notified that any dissemination, distribution, copying
          or disclosure of this communication and any attachment is strictly
          prohibited. If you have received this transmission in error, please
          notify the sender immediately by telephone and electronic mail,
          and delete the original communication and any attachment from any
          computer, server or other electronic recording or storage device
          or medium. Receipt by anyone other than the intended recipient is
          not a waiver of any attorney-client, physician-patient or other
          privilege. Thank you.

          ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
          CLICK ME LINKS:
          Coding Certification & CEU TeleCourseTM Training & Videos
          http://www.crn-institute.com
          E&M Training Videos
          http://www.mhcconsulting.com/
          ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
          CRN Homepage:
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          ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
          CLICK ME LINKS:
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          _____________________________________________________________________

          The information contained in this electronic e-mail transmission
          and any attachments are intended only for the use of the individual
          or entity to whom or to which it is addressed, and may contain
          information that is privileged, confidential and exempt from
          disclosure under applicable law. If the reader of this communication
          is not the intended recipient, or the employee or agent responsible
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          are hereby notified that any dissemination, distribution, copying
          or disclosure of this communication and any attachment is strictly
          prohibited. If you have received this transmission in error, please
          notify the sender immediately by telephone and electronic mail,
          and delete the original communication and any attachment from any
          computer, server or other electronic recording or storage device
          or medium. Receipt by anyone other than the intended recipient is
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          privilege. Thank you.
        • Karen Pyrz
          Thank you to one and all that answered this is exactly the information I needed. Karen ... You can also state that you could not get the HPI from patient
          Message 4 of 12 , May 2 9:15 AM
            Thank you to one and all that answered this is exactly the information I needed.
            Karen

            >>> b.cobuzzi@... 05/02/03 10:20AM >>>
            You can also state that you could not get the HPI from patient because
            they were unconscious, that is ok and counts as complete.

            Barbara

            Barbara J. Cobuzzi, MBA, CPC, CPC-H, CHBME
            President, Cash Flow Solutions, Inc. Lakewood, NJ
            VP, Coding and Reimbursement Network
            Networker of the Year for the American Academy of Professional Coders
            1999
            Member of the National Advisory Board, American Academy of Professional
            Coders
            (732) 364-0123 x200 Voice (732) 364-9111 Fax
            ___________________________________________

            Attention! This electronic message contains information that may be
            legally confidential and/or privileged. The information is intended
            solely for the individual or entity named above and access by anyone
            else is unauthorized. If you are not the intended recipient, any
            disclosure, copying, distribution, or use of the contents of this
            information is prohibited and may be unlawful. If you have received
            this electronic transmission in error, please reply immediately to the
            sender that you have received the message in error, and delete it.
            Release/Disclosure Statement


            -----Original Message-----
            From: Hvizdash, Suzan [mailto:hvizdashsh@...]
            Sent: Friday, May 02, 2003 11:19 AM
            To: 'CRN-L@yahoogroups.com'
            Subject: RE: [CRN-L] Intra-operative consultation

            Because the PFSH and the ROS can be captured by anyone, this information
            can
            be conveyed by the referring physician, the chart, the nurse, etc. The
            HPI
            would be of a limited nature, because of the current state of the
            patient.
            However, that too should be documented. The physical and the MDM can be
            done. The coding would then be based on the required elements.

            Suzan

            > -----Original Message-----
            > From: mrivera@... [SMTP:mrivera@...]
            > Sent: Friday, May 02, 2003 10:59 AM
            > To: CRN-L@yahoogroups.com
            > Subject: RE: [CRN-L] Intra-operative consultation
            >
            > I don't think you can. The elements that comprise an E&M consultation
            are
            > not there: ROS? actual physical exam? PFSH?
            >
            > -----Original Message-----
            > From: Karen Pyrz [mailto:kpyrz@...]
            > Sent: Friday, May 02, 2003 9:32 AM
            > To: CRN-L@yahoogroups.com
            > Subject: Re: [CRN-L] Intra-operative consultation
            >
            >
            > I'm trying again, no one responded yesterday.... ANY help is
            > appreciated.
            >
            >
            >
            > >>> kpyrz@... 05/01/03 03:41PM >>>
            > I am interested in learning how anyone is coding an intra-operative
            > consultation. If the surgeon is requested to come into the
            > operating room (actually scrubs and spends at least 1 hour) to render
            > his opinion, he may not acutally perform any part of the operation,
            > can we code an inpatient consultation? Any and all opinions are
            > appreciated.
            >
            > Thank you
            > Karen
            >
            >
            >
            > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
            > CLICK ME LINKS:
            > Coding Certification & CEU TeleCourseTM Training & Videos
            > http://www.crn-institute.com
            > E&M Training Videos
            > http://www.mhcconsulting.com/
            > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
            > CRN Homepage:
            > http://www.codingandreimbursement.net
            > Become a CRN Gold Member!
            > http://www.codingandreimbursement.net/GoGold.htm
            > Advertiser Options
            > http://www.codingandreimbursement.net/adverting.htm
            > Change your subscription settings (i.e.. digest or vacation mode)
            > http://groups.yahoo.com/group/crn-l/join
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            > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
            >
            >
            > Your use of Yahoo! Groups is subject to
            http://docs.yahoo.com/info/terms/
            >
            >
            > [Non-text portions of this message have been removed]
            >
            >
            > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
            > CLICK ME LINKS:
            > Coding Certification & CEU TeleCourseTM Training & Videos
            > http://www.crn-institute.com
            > E&M Training Videos
            > http://www.mhcconsulting.com/
            > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
            > CRN Homepage:
            > http://www.codingandreimbursement.net
            > Become a CRN Gold Member!
            > http://www.codingandreimbursement.net/GoGold.htm
            > Advertiser Options
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            >
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            >
            > _____________________________________________________________________
            >
            > The information contained in this electronic e-mail transmission
            > and any attachments are intended only for the use of the individual
            > or entity to whom or to which it is addressed, and may contain
            > information that is privileged, confidential and exempt from
            > disclosure under applicable law. If the reader of this communication
            > is not the intended recipient, or the employee or agent responsible
            > for delivering this communication to the intended recipient, you
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          • Jo Ann Steigerwald
            Karen, So long as he Meets the requirements (report, etc) he can bill a consult; do keep in mind that the H&P are going to be pretty limited in this situation
            Message 5 of 12 , May 2 8:01 PM
              Karen,

              So long as he Meets the requirements (report, etc) he can bill a consult;
              do keep in mind that the H&P are going to be pretty limited in this
              situation so you're not going to have a very high level consult and of
              course, its not "counseling time" that is being billed.

              Jo Ann S

              At 08:32 AM 5/2/2003 -0500, you wrote:
              >I'm trying again, no one responded yesterday.... ANY help is
              >appreciated.
              >
              >
              >
              > >>> kpyrz@... 05/01/03 03:41PM >>>
              >I am interested in learning how anyone is coding an intra-operative
              >consultation. If the surgeon is requested to come into the
              >operating room (actually scrubs and spends at least 1 hour) to render
              >his opinion, he may not acutally perform any part of the operation,
              >can we code an inpatient consultation? Any and all opinions are
              >appreciated.
              >
              >Thank you
              >Karen
              >
              >
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              JoAnn S
              Medical Business Specialists
              608 355 2583
              fax 8016087359


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