2023 | List With Consultation CPT Codes (Long & Short Descriptions)

The first consultation CPT codes includes Inpatient or Observation codes for new or established patients [Codes: 99252, 99253, 99254, 99255]. These codes are typically used in relation to services provided in a hospital or other inpatient setting, be it for new or established patients.

Secondly, there are Consultation CPT codes for Interprofessional Internet, EHR, or Telephone consultations [Codes: 99446, 99447, 99448, 99449, 99451]. These codes are used to report interprofessional consultations conducted through online or telephonic mediums.

Next, are Office/Outpatient Consultation codes for new or established patients [Codes: 99242, 99243, 99244, 99245]. These codes are applicable for consultations conducted in a practitioner’s office or an outpatient setting.

Then, there are Pathology Clinical Consultation codes, which are used for consultations related to pathology. The specified codes for an additional 30 minutes of consultation is 80506. For highly complex cases that take 41-60 minutes, the code is 80505. For limited cases needing 5-20 minutes, the code is 80503. And for moderately complex cases that take 21-40 minutes, the code is 80504.

We also have desribed consultation CPT codes for Pathology, Surgical [Codes: 88321, 88323, 88325], which cover consultations for surgical pathology. These are often used when there is a need for consultation during surgery, with codes specified for such situations [Codes: 88329, 88331, 88332, 88333, 88334].

Mental health consultations with a patient’s family or caregiver are listed under the Psychiatric, With Family/Caregiver header [Code: 90887].

Radiation Therapy, Medical Physics are covered with CPT Codes 77336, and 77370 and are related to radiation therapy and medical physics consultations.

Finally, should there be a need for consultation on X-rays made externally, there is a code for that as well [Code: 76140].

CPT Code 99252

Long description: Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.

Short description: Inpatient/observation consultation, straightforward decision-making.

CPT Code 99253

Long description: Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.

Short description: Inpatient/observation consultation, low level decision-making.

CPT Code 99254

Long description: Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the encounter date for code selection, 60 minutes must be met or exceeded.

Short description: Inpatient/ observation consultation, moderate level of decision making.

CPT Code 99255

Long description: Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.

Short description: Inpatient/ observation consultation, high-level decision making

CPT Code 99446

Long description: Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and review.

Short description: Interprofessional internet/ telephone consultation, 5-10 minutes.

CPT Code 99447

Long description: Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional; 11-20 minutes of medical consultative discussion and review.

Short description: Internet/telephone consultation, 11-20 minutes.

CPT Code 99448

Long description: Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patient’s treating/requesting physician or qualified health care professional; 21-30 minutes of medical consultative discussion and review.

Short description: Internet/telephone consultation, 21-30 minutes.

CPT Code 99449

Long description: Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional; 31 minutes or more of medical consultative discussion and review.

Short description: Internet/telephone consultation, 31+ minutes.

CPT Code 99451

Long description: Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time.

Short description: Internet/telephone, written consultation, 5+ minutes.

CPT Code 99242

Long description: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.

Short description: Outpatient consultation, straightforward decision making.

CPT Code 99243

Long description: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Short description: Outpatient consultation, low level decision making.

CPT Code 99244

Long description: Office or other outpatient consultation for a new or established patient , which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.

Short description: Outpatient consultation, moderate level decision making.

CPT Code 99245

Long description: Office or other outpatient consultation for a new or established patient , which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.

Short description: Outpatient consultation, high level decision making.

CPT Code 80506

Long description of CPT Code 80506: Pathology clinical consultation; prolonged service, each additional 30 minutes [List separately in addition to code for primary procedure]

Short description: Pathology clinical consultation with extra service time.

CPT Code 80505

Long description of CPT Code 80505: Pathology clinical consultation;for a highly complex clinical problem, with comprehensive review of patient’s history and medical records and high level of medical decision makingWhen using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.

Short description: Consultation for a highly complex problem in pathology.

CPT Code 80503

Long description of CPT Code 80503: Pathology clinical consultation;for a clinical problem, with limited review of patient’s history and medical records and straightforward medical decision making. When using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.

Short description: Consultation for simple problem in pathology.

CPT Code 80504

Long description of CPT Code 80504: Pathology clinical consultation;for a moderately complex clinical problem, with review of patient’s history and medical records and moderate level of medical decision making. When using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.

Short description: Consultation for moderately complex problem in pathology

CPT Code 88321

Long description of CPT Code 88321: Consultation and report on referred slides prepared elsewhere.

Short description: Consultation on externally prepared slides.

CPT Code 88323

Long description of CPT Code 88323: Consultation and report on referred material requiring preparation of slides.

Short description: Slide preparation consultation.

CPT Code 88325

Long description of CPT Code 88325: Consultation, comprehensive, with review of records and specimens, with report on referred material.

Short description: Comprehensive consultation on referenced material.

CPT Code 88329

Long description of CPT Code 88329: Pathology consultation during surgery.

Short description: Surgical pathology consultation.

CPT Code 88331

Long description of CPT Code 88331: Pathology consultation during surgery first tissue block, with frozen section[s], single specimen.

Short description: First tissue block consultation during surgery.

CPT Code 88332

Long description of CPT Code 88332: Pathology consultation during surgery; each additional tissue block with frozen section[s] [List separately in addition to code for primary procedure].

Short description: Additional tissue block consultation during surgery

CPT Code 88333

Long description of CPT Code 88333: Pathology consultation during surgery cytologic examination [e.g., touch prep, squash prep], initial site.

Short description: Initial cytologic examination consultation during surgery.

CPT Code 88334

Long description of CPT Code 88334: Pathology consultation during surgery; cytologic examination [e.g., touch prep, squash prep], each additional site [List separately in addition to code for primary procedure].

Short description: Subsequent cytologic examination consultation during surgery.

CPT Code 90887

Long description of CPT Code 90887: Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient.

Short description: Consultation on psychiatric interpretation and advisement.

CPT Code 77336

Long description of CPT Code 77336: Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy.

Short description: Medical physics consultation .

CPT Code 77370

Long description of CPT Code 77370: Special medical radiation physics consultation.

Short description: Special radiation physics consultation.

CPT Code 76140

Long description of CPT Code 76140: Consultation on X-ray examination made elsewhere, written report.

Short description: Consultation on external X-ray exam.