AMA CPT® Assistant - 2023 Issue 10 (October)

Questions and Answers (October 2023)

October 2023 page 18 Questions and Answers Evaluation and Management (E/M): Consultations Question: If consulted to evaluate a patient with multiple managed comorbidities such as diabetes, hypertension, or heart disease prior to a low-risk procedure, what level of evaluation and management (E/M) services may be reported? Answer: If requested by another physician or other qualified health care professional (QHP) to evaluate a patient regarding clearance to proceed with a planned low-risk procedure, this service may be reported with an appropriate consultation code (99242-99245, assuming outpatient) depending on the place and level of service. Even if a procedure is low...

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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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