This page addresses follow-up questions and additional information pertinent to our webinar
E/M Coding Essentials: Navigating Inpatient and Outpatient Consultations.

** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.

Q: How do you know if a payer accepts consultation codes or not?
A: You must check payer policy to find out. Check with your billing department, they also may have a list based on denials.

Q: What if my facility doesn’t use consult codes?
A: Based on the number of payers that do not accept consultation codes, that very well may be the case. If this is the facility’s policy, follow the Medicare instructions for all payers or follow specific policies from your organization.

Q: What is the benefit of using consultation codes if the accepts them?
A: Consultation codes may have a higher reimbursement rate.

Q: Can you bill a consultation if the patient of family requested it?
A: No- not under CPT guidelines. It must be requested by a physician or other qualified health care professional. If the patient self-refers, use the appropriate new or established E/M visit code.