Question

question 8

a pcp transfers a patient to a cardiologist for management of the patients congestive heart failure. the cardiologist examines the patient, discusses treatment options and schedules a stress test for this new patient. a report is sent to the pcp detailing the findings of the office visit, results of the stress test and intent to manage and treat the congestive heart failure. an e/m code would be selected from what subcategory for the cardiologist?

office consultation
inpatient consultation
new patient office visit
established patient office visit

Explanation:

Analyze the clinical scenario and transfer of care

The Primary Care Provider (PCP) transfers the patient to a cardiologist for the complete management of the patient's congestive heart failure. When a physician transfers the complete care of a patient for a specific condition to another physician, it is considered a transfer of care rather than a consultation.

Distinguish between consultation and office visit

For a consultation, the specialist must provide an opinion or advice and return the patient back to the referring physician for treatment. Because the cardiologist is taking over the management and treatment of the condition (transfer of care), consultation codes cannot be billed.

Determine the correct E/M subcategory

The patient is explicitly described as a "new patient" being seen in the cardiologist's office. Therefore, the appropriate Evaluation and Management (E/M) subcategory is for a new patient office visit.

Answer:

• Office consultation
• Inpatient consultation
• New patient office visit (Correct answer)
• Established patient office visit