ED Coding & Reimbursement Alert - 2006 Issue 1
Now's the Time to Update Your Consult Coding
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Article Overview
This article reviews changes to consultation coding in CPT 2006, including how consult-related services are reported across inpatient, nursing facility, and office settings. It is aimed at coders and billing staff who need to understand the updated E/M framework, payer-mandated service reporting, and the role of modifier 32 in mandated situations.
Why This Topic Matters
Consult coding changes can affect claim selection, compliance, and payer reporting across multiple care settings. Understanding the updated CPT guidance helps reduce coding errors when consultation services are requested, mandated, or replaced by other E/M categories.
Article Sections
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Mandated services and modifier 32
Introduces the article’s focus on payer-mandated services and the reporting considerations associated with them.
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CPT 2006 consultation code changes
Summarizes the major consultation coding updates discussed for the 2006 CPT release across inpatient and related care settings.
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Requested consultations and appropriate source requirements
Addresses the general requirement for a consultation request to originate from an appropriate source and the implications for reporting.
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Further information
Points readers to additional source material for expanded discussion of the topic.
What You Will Learn
- How CPT 2006 affected consultation coding categories
- How reporting differs across inpatient, nursing facility, and office settings
- When payer-mandated services are discussed in relation to modifier 32
- What general source requirements are described for consultation requests
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Physician practice staff
- Surgery department coding personnel
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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