Outpatient Facility Coding Alert - 2022 Issue 11
E/M CPT® Update: Hone Your Office/Outpatient Consultation Coding Skills for 2023
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Article Overview
This article explains the 2023 updates to CPT office and outpatient consultation evaluation and management coding. It is aimed at coders, billers, and clinical documentation staff who need to understand the revised consultation guidelines, documentation options, place-of-service language, and related prolonged service considerations across payer policies.
Why This Topic Matters
The changes affect how consultation services are described, documented, and reported, so coding teams need to understand the updated framework to support accurate claim submission and payer compliance for 2023.
Article Sections
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See What’s New in Consultation Section Guidelines
Introduces the 2023 consultation guideline updates, including changes to who may provide the service and the revised place-of-service language.
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Choose the Correct Consultation Code via Time or MDM
Explains the updated approach to selecting consultation visit levels using either total time or medical decision making and discusses documentation considerations.
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Focus on Revised Office/Outpatient Consultation Codes
Summarizes the 2023 changes to the consultation code set, including the deleted code and the revised code descriptors and time-based thresholds.
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Time
Covers prolonged service considerations tied to time-based consultation reporting and notes that payer policies may differ.
What You Will Learn
- How the 2023 consultation guidelines changed for office and outpatient settings
- How time and medical decision making can be used for consultation code selection
- Which consultation code was deleted and which codes were revised
- How prolonged service reporting is discussed in relation to consultation visits
- Why payer-specific policies still matter for consultation claims
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Clinical documentation specialists
- Revenue cycle teams
Codes Discussed
Modifiers Discussed
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