AMA CPT® Assistant - 2014 Issue 9 (September)

Evaluation and Management: Consultations (Q&A) (September 2014)

September 2014 page 13 Evaluation and Management: Consultations Question: A patient visits the office of an ear, nose, and throat (ENT) specialist and tells the office staff that a general practitioner referred him to a specialist for an ongoing problem with sinusitis. The ENT office has not received an oral or written request from the general practitioner's office. Can this patient visit be reported as a consultation (99241-99245) based upon the patient's statement? Answer: No. If the presumed referring physician does not communicate a formal request for a consultation, either in verbal or written form, this is not a...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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