E/M Consultation Services

Aka: E/M Consultation Services, E/M Consultation, CPT 99241, CPT 99242, CPT 99243, CPT 99244, CPT 99245

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II. Indication

  1. Outpatient Consultation

III. Outpatient Consultation: CPT Code 99241

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Problem Focused History
    2. E/M Problem Focused Exam
    3. E/M Straightforward Medical Decision
  2. E/M Self Limited or Minor Problem
  3. Physician Time: 15 minutes

IV. Established Outpatient: CPT Code 99242

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Expanded Problem Focused History
    2. E/M Expanded Problem Focused Exam
    3. E/M Straightforward Medical Decision
  2. E/M Low Severity Problem
  3. Physician Time: 30 minutes

V. Outpatient Consultation: CPT Code 99243

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Detailed History
    2. E/M Detailed Exam
    3. E/M Low Complexity Medical Decision
  2. E/M Moderate Severity Problem
  3. Physician Time: 40 minutes

VI. Outpatient Consultation: CPT Code 99244

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Comprehensive History
    2. E/M Comprehensive Exam
    3. E/M Moderate Complexity Medical Decision
  2. Problem Severity
    1. E/M Moderate Severity Problem
    2. E/M High Severity Problem
  3. Physician Time: 60 minutes

VII. Outpatient Consultation: CPT Code 99245

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Comprehensive History
    2. E/M Comprehensive Exam
    3. E/M High Complexity Medical Decision
  2. Problem Severity
    1. E/M Moderate Severity Problem
    2. E/M High Severity Problem
  3. Physician Time: 80 minutes

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Related Studies

Ontology: Consultation (C0009818)

Definition (NCI) A conference between two or more people to consider a particular question; the act of deliberating together; confering with another researcher, physician, or expert about an issue or a case.
Definition (NIC) Using expert knowledge to work with those who seek help in problem solving to enable individuals, families, groups, or agencies to achieve identified goals
Concepts Health Care Activity (T058)
MSH D012017
ICD9 89.09
SnomedCT 11429006, 223475005
CPT 1013686
LNC LA7553-6, LA12066-9
English Consultations, Consult, Consultation NOS, consulting, consult, consulted, consults, consultations, Consultation with healthcare provider, consultation, consultation (treatment), Consultation Services, Consults, Consulting with, Consultation (procedure), Consulting with (procedure), Consultation, NOS, Consultation, not otherwise specified, Consultation
Portuguese Consulta
Spanish Consulta, consulta (procedimiento), consultar con (procedimiento), consultar con, consulta
German Konsultation
French Consultation
Czech konzultace
Norwegian Konsultasjon
Dutch Consult
Derived from the NIH UMLS (Unified Medical Language System)

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