Remember the rules governing consultations

Why This Topic Matters

Consultations often reimburse differently from routine E/M visits and have stricter documentation requirements. Understanding the governing rules helps reduce denials, support compliant reporting, and avoid problems related to request, encounter type, treatment initiation, and follow-up reporting.

Article Sections

1. Consultation scenarios and reimbursement context

   Introduces common referral situations in which interventionalists may be asked to provide an opinion or evaluation. It also frames consultations as a higher-level E/M service with stricter oversight than routine outpatient visits.

2. Five rules to keep in mind

   Summarizes the main compliance topics discussed in the article. The section covers the request for advice, face-to-face evaluation, transfer-of-care concerns, treatment during the encounter, and reporting back to the requesting source.

3. Official resource

   Points readers to an external CMS manual resource for further review of consultation guidance.