Keyword Analysis & Research: consultation dx


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Frequently Asked Questions

What is the CPT code for a consultation?

A consultation requested by a patient is not reported by using consultation codes; rather, it is reported by using the appropriate E/M code. A patient requesting a second opinion or a consultation does not meet the CPT definition of a consultation code.

What is a a consultation?

A consultation, as defined by the CPT manual, is a evaluation and management service provided at the request of another physician or appropriate source to either recommend care for a specific condition or problem, or to determine whether to accept responsibility for ongoing management...

How do I Bill for a consultation?

Consultations can only be billed out when requested by another physician or appropriate source. A consultation requested by a patient is not reported by using consultation codes; rather, it is reported by using the appropriate E/M code.

What happens if a patient does not request a consultation?

Patients or a patient’s family may not request a consultation. An evaluation and management (E/M) service “not requested by a physician or other appropriate source … is not reported using the consultation codes but may be reported using the office visit, home service or domiciliary/rest home care codes,” according to CPT ® guidelines.


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