Section 418.10205. Consultation services.

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(1) An attending physician, carrier, third-party administrator, or the injured worker may request a consultation. Codes 99241-99245 and 99251-99255 shall not be used for consultation examinations. Providers shall use the evaluation code that most accurately reflects the service rendered.

(2)If a specialist performs diagnostic procedures or testing in addition to the evaluation, then the specialist shall bill the appropriate procedure code from "Physicians' Current Procedural Terminology (CPT®). The carrier shall reimburse the testing procedures in accordance with these rules.

History: 2000 AACS; 2002 AACS; 2010 AACS.

                    
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