Advanced Search

Orthopedic Coding Alert

Reader Question:

Confirmatory Consultation

Published on Sat Dec 01, 2001

Question: Should I bill for a confirmatory consultation when a patient requests a second opinion because there is no referring physician?

Kansas Subscriber
 
 Answer: Your question defines perfectly the purpose of a confirmatory consultation, which is commonly a patient-requested service. In the confirmatory consultation category in CPT, it states, The following codes are used to report the E/M services procedure to patients when the consulting physician is aware of the confirmatory nature of the opinion sought (e.g., when a second/third opinion is requested or required on the necessity or appropriateness of a previously recommended medical treatment or surgical procedure). You should report 99271-99275 (confirmatory consultation) for the service you describe.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Orthopedic Coding Alert

View All