AMA CPT® Assistant - 2023 Issue 3 (March)
Evaluation and Management (E/M) Consultation Services Code Changes for 2023 (March 2023)
March 2023 pages 13-18 Evaluation and Management (E/M) Consultation Services Code Changes for 2023 For the Current Procedural Terminology (CPT®) 2023 code set, the E/M consultation subsection guidelines and code descriptors were significantly revised as part of the continuous effort to simplify administrative processes when providing E/M services. A consultation is defined in the CPT 2023 code set as “a type of evaluation and management service provided at the request of another physician, other qualified health care professional, or appropriate source to recommend care for a specific condition or problem.” These services are used across numerous care...
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Article Overview
This article explains the 2023 revisions to CPT evaluation and management consultation services. It covers updated consultation guidelines, changes to office or other outpatient consultation codes, changes to inpatient or observation consultation codes, and the related prolonged service add-on codes. It is intended for coding professionals, billers, and clinicians who need to understand how the 2023 consultation service framework is organized.
Why This Topic Matters
Consultation coding changed significantly in 2023, affecting how consultative E/M services are categorized and reported across outpatient, inpatient, and observation settings. Understanding the revised structure helps readers determine whether the article is relevant to their coding workflow and policy review needs.
Article Sections
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March 2023 pages 13-18
Introductory article framing and a high-level overview of the 2023 consultation service revisions in CPT. The section sets the scope for the guideline and code changes discussed in the rest of the article.
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Guideline Revisions
General updates to consultation service guidelines, including changes in terminology, reporting context, and how follow-up services are addressed within the consultation framework.
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Office or Other Outpatient Consultations
The outpatient consultation subsection for new or established patients, including the 2023 code structure and time-based framework associated with these services.
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Coding Tip
A brief guidance note focused on the time-based approach described in the outpatient consultation section. It highlights how the article presents prolonged service reporting in that context.
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Inpatient or Observation Consultations
The inpatient and observation consultation subsection, including the revised service structure and the associated time-based framework for 2023.
What You Will Learn
- How the 2023 consultation service article is organized
- What types of guideline updates were made for consultation services
- How the article separates outpatient from inpatient or observation consultation coverage
- What broad topics are addressed in relation to prolonged service reporting
- Which organizations and code sets are referenced in the consultation update discussion
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Physician practice managers
- Compliance professionals
- Clinicians involved in consultation services
Codes Discussed
Code Ranges Discussed
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