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

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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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
English Consultation and report, Consultations, Consultation, NOS, Consult, CONSULT, Consultation NOS, consulting, consult, consultation, consulted, consults, consultations, Consulting with, Consultation (procedure), Consulting with (procedure), Consultation, not otherwise specified, Consultation
Portuguese Consulta
Spanish Consulta, consulta (procedimiento), consultar con (procedimiento), consultar con, consulta
German Konsultation
French Consultation
Czech konzultace
Dutch Consult