AAPC Certified Professional Medical Auditor (CPMA) Practice Exam 2025 - Free CPMA Practice Questions and Study Guide

Billing for a consultation involves specific requirements that ensure the service is medically necessary and well-documented. The correct answer emphasizes the necessity of a referral from another provider, which establishes the context for the consultation. This referral must include a recommendation addressing a specific condition, allowing the consulting provider to understand the purpose of the visit clearly. Furthermore, a written report summarizing the findings and suggestions for the patient's care is vital for documentation purposes and communication back to the referring provider.

Having a thorough documentation process, including the referral and written report, helps to justify the consultation billing and ensures compliance with coding regulations. This comprehensive approach not only fulfills billing requirements but also enhances the continuity of care for the patient. Without these components, the consultation may lack the necessary substantiation to support the billing process.