October 2023 page 18
Questions and Answers
Evaluation and Management (E/M): Consultations
Question: If consulted to evaluate a patient with multiple managed comorbidities such as diabetes, hypertension, or heart disease prior
to a low-risk procedure, what level of evaluation and management (E/M) services may be reported?
Answer: If requested by another physician or other qualified health care professional (QHP) to evaluate a patient regarding clearance
to proceed with a planned low-risk procedure, this service may be reported with an appropriate consultation code (99242-99245, assuming outpatient) depending on the place and level of service. Even if a procedure is low...
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