If you work in General Surgery or Hematology Oncology the following fee codes have been amended:
General Surgery
As of August 1st, 2021, fee code 71691 – Hemorrhoid(s) was amended to update Service Locations Codes in Teleplan. This fee code is no longer payable in a public facility. It is only payable when performed in an office (Service Location code Q or T).
Hematology and Oncology
As of September 1st, 2021, the following fee codes are amended to remove note ii from their descriptions:
Fee codes 33520 Complex Consultation and 33540 Telehealth Complex Consultation
Both include examination, review of history, laboratory, X-ray findings, and additional visits required to provide a written report for a complex patient.
33520 and 33540 details:
- This fee code is limited to Hematology and Oncology.
- The maximum payment is for one patient within 6 months of their previous visit.
- Only patients who are directly receiving treatment for hematological diseases such as:
- Multiple myeloma (not including monoclonal paraproteinemia/ monoclonal gammopathy of undetermined significance)
- Acute leukemia (not including chronic lymphocytic leukemia)
- Hereditary hemolytic anemia
- Acquired hemolytic anemia
- Aplastic anemia and red cell aplasia
The following diseases are also eligible, provided they meet qualifying features:
- Myelodysplastic syndrome or Myelofibrosis requiring chemotherapy, transfusion or growth factor therapy
- Coagulation defects requiring factor concentrate, transfusion or other hemostatic therapy
- Thrombocytopenia requiring immunosuppressive, transfusion or growth factor therapy
- Venous thromboembolism (VTE) / Phlebitis and thrombophlebitis that is:
- o unprovoked,
- o in a patient with cancer,
- o in a pregnant patient, or
- o in a patient with a contraindication to anticoagulation.
33522 Repeat or Limited Consultation, Complex Patient
If within a six-month period, you provide a consultation for the same illness twice, or you determine the consultative services don’t warrant a full consultative fee you can bill 33522.
Details:
- This fee code is limited to Hematology and Oncology.
- This fee code applies to complex patients (notes can be found under 33520 – Complex Consultation)
33527 Subsequent Office Visit, Complex Patient
Details:
- This fee code is limited to Hematology and Oncology.
- This fee code applies to complex patients (notes can be found under 33520 – Complex Consultation)
- The payment is not dependant on a Complex Consultation or Telehealth Complex Consultation being billed within the last 6 months.
33542 Telehealth Repeat or Limited Consultation, Complex Patient
If within a six-month period, you provide a consultation for the same illness twice, or you determine the consultative services don’t warrant a full consultative fee.
Details:
- This fee code is limited to Hematology and Oncology
- This fee code applies to patients who are directly receiving treatment for hematological diseases, listed under 33520.
33547 Telehealth Subsequent Office Visit, Complex Patient
Details:
- This fee code is limited to Hematology and Oncology
- This fee code applies to patients who are directly receiving treatment for hematological diseases, listed under 33520.
- The payment is not dependant on a Complex Consultation or Telehealth Complex Consultation being billed within the last 6 months.
33522 Repeat or Limited Consultation, Complex Patient
If within a six-month period, you provide a consultation for the same illness twice, or you determine the consultative services don’t warrant a full consultative fee.
Details:
- This fee code is limited to Hematology and Oncology
- This fee code applies to patients who are directly receiving treatment for hematological diseases, listed under 33520.
33527 Subsequent Office Visit, Complex Patient
Details:
- This fee code is limited to Hematology and Oncology
- This fee code applies to patients who are directly receiving treatment for hematological diseases, listed under 33520.
- The payment is not dependant on a Complex Consultation or Telehealth Complex Consultation being billed within the last 6 months.
33542 Telehealth Repeat or Limited Consultation, Complex Patient
If within a six-month period, you provide a consultation for the same illness twice, or you determine the consultative services don’t warrant a full consultative fee.
Details:
- This fee code is limited to Hematology and Oncology
- This fee code applies to patients who are directly receiving treatment for hematological diseases, listed under 33520.
33547 Telehealth Subsequent Office Visit, Complex Patient
Details:
- This fee code is limited to Hematology and Oncology
- This fee code applies to patients who are directly receiving treatment for hematological diseases, listed under 33520.
- The payment is not dependant on a Complex Consultation or Telehealth Complex Consultation being billed within the last 6 months.
Keeping yourself informed on the amendments to fee codes that pertain to your practice will make sure you are paid appropriately for your time. If you have any questions about these updates, don’t hesitate to get in touch with our team.
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
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