3 Q&As to sharpen your consult coding skills

Why This Topic Matters

Consultation coding is a frequent source of denials, audits, and inconsistent reporting. Understanding the broad guidance summarized here helps practices align billing with payer expectations and avoid mistakes in consult reporting across different care settings.

Article Sections

1. Consultant assumes care of problem

   Discusses how consultation reporting is affected when the consultant continues to manage the problem after the initial visit. The section focuses on the broader issue of intent, reporting expectations, and continued care under Medicare and CMS guidance.

2. Codes to bill for ED consults

   Covers emergency department consultation reporting and the general category of consultation and office/outpatient visit coding involved. It also addresses how ED-related encounters are distinguished from other referral patterns.

3. Two physicians consult the same day

   Addresses same-day consultation reporting when more than one physician in a practice is involved. The section also touches on related Medicare and CPT considerations for group practice billing.