Simple Questions Cut Through Consultation Confusion

Article Overview

This article explains consultation billing issues for general surgery practices and reviews the general criteria used to distinguish consults from other evaluation and management services. It discusses how CMS and CPT guidance, Medicare manual language, service location, and care-transfer considerations can affect whether a consultation is reportable and how it may be billed. The piece is aimed at coders, billers, and reimbursement staff who need to understand consult documentation and reporting basics without relying on assumptions about the patient’s condition or the encounter setting.