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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 moderate complexity. Counseling and/or coordination of care with other physic

CPT4 code

Name of the Procedure:

Office Consultation for a New or Established Patient

Common Names: Initial Consultation, Follow-Up Visit, Patient Evaluation

Summary

An office consultation involves a thorough evaluation by a healthcare provider for both new and established patients. It includes a comprehensive history, detailed physical examination, and moderate complexity medical decision-making. The consultation may involve discussions about the patient’s health concerns and coordination of care with other healthcare professionals as needed.

Purpose

Medical Condition or Problem It Addresses: This consultation is crucial for diagnosing and managing various health issues, ranging from acute illnesses to chronic conditions.

Goals or Expected Outcomes:

  • To obtain a thorough understanding of the patient's medical history.
  • To perform a detailed physical examination.
  • To develop a medical plan with moderate complexity decision-making.
  • To provide appropriate counseling and coordinate care with other healthcare professionals.

Indications

Specific Symptoms or Conditions:

  • Acute symptoms like pain, infections, or injuries.
  • Chronic conditions such as diabetes, hypertension, or asthma.
  • Preventive care and routine check-ups.
  • Follow-up for ongoing treatments or recently diagnosed conditions.

Patient Criteria:

  • New patients presenting for initial evaluation.
  • Established patients requiring ongoing care or follow-up.

Preparation

Pre-procedure Instructions:

  • Bringing a list of current medications.
  • Having previous medical records available (if possible).
  • Fasting is not typically required unless specified for specific diagnostic tests.

Diagnostic Tests or Assessments:

  • Previous lab results, imaging studies, or specialist reports may be reviewed.
  • New tests may be ordered as part of the decision-making process.

Procedure Description

  1. Comprehensive History: The provider will gather detailed information about the patient's medical history, family history, lifestyle, and current symptoms.
  2. Comprehensive Examination: A full physical examination will be conducted to assess the patient's overall health.
  3. Medical Decision Making: The provider will evaluate findings from the history and examination to develop a moderate complexity medical plan, which may include diagnostic tests, treatment options, and referrals.

Tools, Equipment, or Technology Used:

  • Stethoscope, blood pressure cuff, otoscope, and other physical examination tools.
  • Electronic health records (EHR) for documentation and review of past medical history.

Anesthesia or Sedation: Not applicable for this procedure.

Duration

Typically, the consultation lasts between 30 to 60 minutes.

Setting

The procedure is performed in an outpatient clinic or a doctor's office.

Personnel

  • Primary Care Physician or Specialist
  • Nurse or Medical Assistant for initial intake and support

Risks and Complications

  • There are minimal risks associated with the consultation itself.
  • The potential risk is missing an important diagnosis if the history or examination is incomplete.

Benefits

  • Accurate diagnosis and management of health issues.
  • Development of a personalized medical plan.
  • Counseling on health maintenance and disease prevention.
  • Coordination with other healthcare providers to ensure comprehensive care.

Expected Benefits Realization: Immediate understanding of health needs and initiation or modification of treatment.

Recovery

Post-procedure Care:

  • Follow the medical plan outlined by the healthcare provider.
  • Adhere to any given prescriptions or referrals.

Expected Recovery Time: As this is a consultation, there is no recovery period. However, follow-up appointments may be necessary based on the provider's recommendations.

Restrictions or Follow-Up:

  • Specific follow-up appointments as advised.
  • Any dietary, activity, or medication adjustments will be communicated during the visit.

Alternatives

Other Treatment Options:

  • Urgent Care for acute symptoms.
  • Specialist consultations for specific conditions.
  • Telemedicine visits for initial consultations or follow-ups.

Pros and Cons of Alternatives:

  • Urgent Care: Quicker for acute symptoms but lacks comprehensive history evaluation.
  • Specialist Consultation: More focused but may require a referral and longer wait times.
  • Telemedicine:
    • Pros: Convenient and accessible, especially for follow-ups.
    • Cons: Limited physical examination capability.

Patient Experience

During the Procedure:

  • Patients can expect a friendly and thorough interaction with the healthcare provider.
  • Detailed questioning about medical history and current symptoms.
  • A complete physical examination.

After the Procedure:

  • Patients may feel relieved having a clear plan of action.
  • Instructions and next steps will be discussed comprehensively.
  • Pain management and comfort are generally not required for this type of visit.
  • Patients may contact the office with any post-visit questions or concerns.

This outline helps provide a clear and comprehensive understanding of what to expect during an office consultation, making the process more transparent and less intimidating for patients.

Medical Policies and Guidelines for 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 moderate complexity. Counseling and/or coordination of care with other physic

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