Second opinions: are they consults?

March 27th, 2009 - Codapedia Editor
Categories:   Coding   Evaluation & Management (E/M)  
 

There are no longer any CPT® codes for confirmatory consults.  If a patient presents to the office with a request for a second opinion, how is that billed?

If the patient is requesting a second opinion, bill that service as a new or established patient, whichever category is correct for that patient encounter.  If another healthcare professional is requesting a second opinion, and the criteria for a consult are met: request, reason, report, then bill an outpatient consult.

On an inpatient basis, only one consult per/specialist is allowed for any admission.  If the physician had performed a consult, signed off the case, and then was asked to come back for another opinion, that service is billed as a subsequent hospital visit.


###   Printed:  June 12th, 2026
Source:  http://www.codapedia.com//article_288_Second_opinions%3A_are_they_consults%3F.cfm