Orthopedic Coding Alert

Reader Question:

Confirmatory Consultation

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.

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