The differences in the two sets of E/M consultation code

What is the step-by-step explanation for the differences in the two sets of E/M consultation code:

In the selection process, a comparison of the E/M level achieved based on one set of criteria versus the other, using the same documents, can be useful. “In addition to the individual requirements of a CPT code, the medical necessity of a service is the overriding criteria for payment. When a lower level of assessment and management service is required, it is not medically necessary or sufficient to bill a higher level of service.” “The amount of documentation should not be the primary factor on how a particular level of service is billed,” CMS adds. Those awarding E/M codes for clinical services performed should take into consideration both the E/M standard reached based on the provider’s documentation and the extent of the patient’s presenting condition when assessing the medical necessity of the experience.

What constitutes the elements that must be in place to be coded to a consultation. In CPT coding:

“A form of service rendered by a physician whose opinion or guidance regarding the diagnosis and/or management of a particular problem is sought by another physician or other relevant source,” according to CPT. Documentation for a consulting service must include three elements: a proposal, a justification, and a report. Purpose is a fourth element that is equally essential. Reporting a consultation code for a specific service always boils down to answering the question.