Which statement best describes consultations in CPT coding?

Which statement best describes consultations in CPT coding?

• A. A request for consultation is required, followed by a recommendation or acceptance of responsibility, and a written report to the requester.
• B. A consultation is the same as a transfer of care.
• C. Consultations are billed only when performed in the ED.
• D. There must be a second opinion.

Answer: (A)

In CPT coding, a consultation is a physician’s input provided at the request of another clinician who is managing the patient. The defining elements are a formal request for the consultation, the consultant’s opinion and either a recommendation or acceptance of responsibility for part of the patient’s care, and a written report sent back to the requester. This setup distinguishes a consultation from a transfer of care, which is about taking over ongoing management. Consultations aren’t limited to the emergency department, and they don’t require a second opinion. So the statement describing a required request for consultation, followed by a recommendation or acceptance of responsibility, and a written report to the requester best describes CPT consultations.

In CPT coding, a consultation is a physician’s input provided at the request of another clinician who is managing the patient. The defining elements are a formal request for the consultation, the consultant’s opinion and either a recommendation or acceptance of responsibility for part of the patient’s care, and a written report sent back to the requester. This setup distinguishes a consultation from a transfer of care, which is about taking over ongoing management. Consultations aren’t limited to the emergency department, and they don’t require a second opinion. So the statement describing a required request for consultation, followed by a recommendation or acceptance of responsibility, and a written report to the requester best describes CPT consultations.