eConsults are available for use by all UTMB departments, effective June 10, 2025. eConsults are an assessment and management service in which the treating provider (faculty or APP) requests advice and/or opinion from a specialist for treatment and/or management of the patient’s problem.
The consultant will be reviewing medical records, testing, etc., only. The consultant may not have contact with the patient, patient’s family, caregiver, sitter, etc. The patient may be new or established to the consultant, however the consultant could not have had a F2F encounter within the past 14 days and the eConsult cannot lead to a F2F encounter within the next 14 days. The eConsult scenario will include the treating provider placing an order to request the eConsult. The treating provider must obtain verbal consent from the patient to allow the consultant to review the patient’s medical records and formulate their advice or opinion. The eConsult is performed through conversations between the two providers via telephone, internet, or the EHR.
The consultant will bill one of the following codes. Three of these codes are based on time and include a verbal and written report. One includes time and a written report only.
99446 – eConsult provided by the consultant including a verbal and written report,
5-10 minutes of consultative discussion and review
99447 – eConsult provided by the consultant including a verbal and written report,
11-20 minutes of consultative discussion and review
99448 – eConsult provided by the consultant including a verbal and written report,
21-30 minutes of consultative discussion and review
99451 – eConsult provided by the consultant including a written report only,
5 or more minutes of consultative discussion and review
Required Documentation:
- eConsult requested by: ____________
- eConsult requested for: ____________
- Patient Consent was obtained by (name the requesting provider)
- Information reviewed to include date and name of testing and studies, medical records reviewed, etc.
- Written report – advice or opinion
- Summary of verbal conversation – when billing 99446 thru 99448
- Time spent
The treating (requesting) provider will decide on which information is to be reviewed and communicate this to the consultant. The treating provider will bill the following code:
99452 – eConsult referral service provided by a treating/requesting provider,
30 minutes
Required Documentation:
- Request for eConsult from: (name the requesting provider)
- Reason for the eConsult:
- Patient Consent – person and relationship to the patient who is consenting
- Confirmation of review of report along with summary of conversation
- Time spent - must have at least 16 minutes to bill 99452 (more than 50% of 30 min)
Revenue Cycle Financial Clearance working in conjunction with Coding Education to bring you information to manage the patient experience for all patients at UTMB. We are dedicated to the education and success of all UTMB providers. Please contact The RCO Financial Clearance and Coding Education Team to ask questions or schedule a meeting. We are here to help! Email the Coding Education Team. |