3 Q&As to sharpen your consult coding skills

Why This Topic Matters

Consultation coding remains an area of payer scrutiny, so understanding the boundaries between consults, new patient services, and ongoing management is important for compliant physician billing. The article is useful for practices looking for high-level guidance on common consult scenarios and the Medicare references tied to them.

Article Sections

1. Consultant assumes care of problem

   Discusses a consultation scenario where the specialist may continue managing the issue after the initial visit. The section addresses the general Medicare/CMS context for consult reporting and transfer-of-care considerations.

2. Codes to bill for ED consults

   Covers consultation billing in the emergency department setting and the related CPT and Medicare context. It also distinguishes ED consult scenarios from other referral outcomes in general terms.

3. Two physicians consult the same day

   Reviews same-day consultation reporting when more than one physician in a group practice sees the same patient for the same issue. The section focuses on general group practice and same-specialty billing considerations.