405 IAC 5-8-2 "Consultation" defined

Sec. 2. 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.