decisionhealth Newsletters, Coder Pink Sheets - 2019 Issue 5 (May)
Understanding E/M: Revised E/M codes allow billing for interprofessional consultations
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Article Overview
This article explains a 2019 CPT update from the AMA affecting interprofessional consultation services conducted through telephone, internet, and electronic health record communication. It is intended for physicians, coders, and billing staff who need to understand the scope of the revised consultation subsection, the new reporting framework, and the documentation and reimbursement implications discussed in the manual. The coverage stays at a general level while addressing the affected CPT subsection, how the services are categorized, and the types of supporting information referenced by the article.
Why This Topic Matters
These changes affect how interprofessional consultations are reported and recognized for payment, so accurate awareness of the revised CPT structure matters to practices managing communication-based care and compliance.
Article Sections
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Overview of the 2019 CPT updates
Introduces the AMA changes to the interprofessional telephone and internet consultations subsection and summarizes the general scope of the update.
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Revisions to existing consultation codes
Describes how previously existing interprofessional consultation services were revised within the CPT manual and discusses the broader impact on reporting and reimbursement.
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Newly added interprofessional consultation codes
Covers the addition of new codes in the same subsection and the general distinction between services described for consulting and requesting clinicians.
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Included services and documentation considerations
Summarizes the types of records and supporting information referenced in the article, along with the documentation elements mentioned in the manual.
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Patient consent and cost-sharing note
Notes the article’s discussion of patient permission and the general billing implication tied to these services.
What You Will Learn
- How the 2019 CPT manual updated the interprofessional consultation subsection
- Which general categories of services were revised or newly introduced
- What types of documentation are discussed for these consultation services
- Why payer recognition and patient consent are relevant to these services
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Compliance professionals
Codes Discussed
Code Ranges Discussed
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