In Billing
Dec 28th, 2017
In August 2017, UnitedHealthcare (UHC) indicated they would no longer reimburse inpatient and outpatient consultation codes, as of Oct. 1, 2017. When the implementation date came, UHC indicated they would delay the consultation services revision until 2018: We previously announced that certain revisions to the Consultation Services Reimbursement Policy would become effective for UnitedHealthcare Co...
Aug 1st, 2013
By G.J. Verhovshek, MA, CPC “Remember the ‘Three Rs’ for Payers Accepting Consults” (June 2013, pages 26-29) generated more than the usual number of reader responses, and a few readers took issue with my insistence that what matters most when coding for consultations are a documented request, reason, and report. Specifically, they suggested what mattered ...
May 1st, 2009
Here’s How to Know for Sure By G.J. Verhovshek, MA, CPC In 2006, the Office of Inspector General (OIG) released the report “Consultations in Medicare: Coding and Reimbursement,” claiming as many as 75 percent of services billed as consultations and allowed by Medicare in 2001 did not meet all applicable program requirements. Even prior to ...