AMA CPT® Assistant - 2008 Issue 11 (November)

Evaluation and Management/Consultations (November 2008)

November 2008 page 10e Evaluation and Management/Consultations Question: In the guidelines for reporting consultations, does the term "physician" include a resident, or is a resident considered an "appropriate source?" Answer: Your question appears to focus on who may request a consultation with respect to payer policy. A resident physician (postgraduate trainee) is a physician. CPT uses the term "physician" in the Evaluation and Management codes to include allopathic physicians, osteopathic physicians, podiatrists, physician's assistants, nurse practitioners, and other qualified health care professionals who may perform such services within their scope of practice. The Consultation guidelines speak to referral...

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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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