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Thread: 2010 Consults - NON MEDICARE

  1. #1

    Default 2010 Consults - NON MEDICARE

    AAPC: Back to School
    Please bare with me....
    In the 2010 CPT book it state "A consultation is a type of evaluation and management service provided by a physician at the request of another physician or appropriate source to either recommend care for a specific condition or problem or to determine whether to accept responsibility for ongoing management of the patient's entire care or for the care of a specific condition or problem"

    So, my question is...as a speciality, really, most of our "consults" really are consults?? - I really am not liking consults!! -
    Does this statement hold true?

    It is a consult the first time the patient is seen. If treatment is started and is managed by your doc, all visits by your doc for that specific treatment are follow up E/m's. If you doc is asked for opinion regarding a different dx during that time of tx or after, he can bill the consult again.

    Thank you!!

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Yes this is the definition of consult per AMA

    The AMA owns and produces the CPT book - NOT Medicare/CMS.

    So yes, this is the definition per AMA.

    Per CPT the provider being asked for a consultation has ALWAYS had the option to begin diagnositcs or treatment of the patient for the condition requiring the consultation.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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