Evaluation and Management/Consultations (August 2009)

August 2009 page 9 Evaluation and Management: Consultations, 99241 (Q&A) Question: May an emergency medicine physician order a consultation for the patient, for the purpose of having the results (opinion or advice) of the consultation sent to and used by another physician in the ongoing management of that aspect of the patient's care? Answer: The CPT guidelines for consultations state, "A consultation is a type of service provided by a physician whose opinion or advice regarding evaluation and/or management of a specific problem is requested by another physician or other appropriate source. The consultant's opinion and any services...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This premium article examines evaluation and management consultation guidance from CPT® Assistant, with a focus on emergency department scenarios and communication of a consultant’s report to another clinician. It is aimed at coders, billers, and clinicians who need to understand the scope of consultation services and related documentation expectations. The discussion stays centered on general consultation policy and a case-based question-and-answer format.

Why This Topic Matters

Consultation coding is frequently affected by who requested the service, how the information is used, and whether the consultant’s findings are communicated appropriately. Understanding this guidance helps support accurate reporting in emergency and follow-up care settings.

Article Sections

  1. August 2009 page 9

    A Q&A discussion of consultation services in an emergency medicine setting. The section addresses documentation, communication, and the relationship between the consulting physician and the requesting or follow-up clinician.

What You Will Learn

  • The general CPT concept of a consultation
  • How consultation guidance is applied in an emergency medicine scenario
  • The importance of documentation and written communication in consultation services
  • How consultation-related information may be used in ongoing patient management

Who Should Read This

  • Medical coders
  • Billing professionals
  • Emergency medicine physicians
  • Consulting physicians
  • Compliance staff

Codes Discussed


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