AMA CPT® Assistant - 2005 Issue 12 (December)

Evaluation and Management: Consultations (December 2005)

December 2005 page 10b Coding Consultation:Questions and Answers Evaluation and Management: Consultations (Q&A) Question Is it appropriate to report a code from the Office or Other Outpatient Consultation code series (99241-99245) if an office consultation is initiated by a patient? AMA Comment As stated in the newly added Consultations guidelines for CPT 2006, “A ‘consultation’ initiated by a patient and/or family, and not requested by a physician, is not reported using the consultation codes but may be reported using the office visit codes, as appropriate.” Therefore, if an office consultation is initiated by a patient...

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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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