405 IAC 5-8-2 - "Consultation" defined
Current through December 29, 2021
Authority: IC 12-15-1-10; IC 12-15-1-15; IC 12-15-21-2
Affected: IC 12-13-7-3; IC 12-15
As used in this rule, "consultation" means the rendering of a medical opinion by a physician for a specific member, regarding evaluation or management of a condition, requested by another physician. It requires the consultant physician to examine the patient, unless the applicable standard of care does not require a physical examination. A confirmatory consultation means a second or third opinion. Reimbursement is available for consultative pathology and radiology services under 405 IAC 5-18 and 405 IAC 5-27, where the consultant physician does not examine the patient.
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