Evaluation And Management
Chapter 2
Section 5.1
Consultations
Issue Date: March 3, 1992
Copyright: CPT only © 2006 American Medical
Association (or such other date of publication of CPT).
All Rights Reserved.
Revision: C-13, November 15, 2017
1.0 CPT PROCEDURE CODE RANGE
99241 - 99255
2.0 DESCRIPTION
A deliberation
with a specialist physician, dentist, or qualified mental health
provider requested by the attending physician primarily responsible
for the medical care of the patient, with respect to the diagnosis
or treatment in any particular case.
3.0 POLICY
3.1 Consultations performed by
an individual professional provider at the request of the patient’s attending
provider are covered.
3.2 A consulting
physician, dentist, or qualified mental health provider may perform
a limited examination of a given system or one requiring a complete
diagnostic history and examination.
3.3 To qualify as
a consultation, a written report to the attending physician of the
consultant’s findings is required.
4.0 EXCLUSIONS
4.1 Telephone
consultations and telephone toll charges are not covered.
4.2 Staff consultations required
by the policies of a hospital or other institution.
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