In CMS
Jun 12th, 2017
Medicare does not accept claims for either outpatient (99241-99245) or inpatient (99251-99255) consultations, and instead requires that services be billed with the most appropriate (non-consultation) E/M code. Report outpatient E/M services with the appropriate Outpatient Services code (e.g., 99201-99215, or 99281-99285 for patients seen in the emergency department). The service must be supported b...
Jul 1st, 2013
CMS says to use E/M codes to report these services, but you’ll have to play by their rules to get paid. By G.J. Verhovshek, MA, CPC, Medicare stopped accepting claims for outpatient (99241-99245) and inpatient (99251-99255) consultations as of Jan. 1, 2010, but physicians haven’t stopped providing these services. How are they getting paid? After ...
Apr 1st, 2013
By Melody S. Irvine, CPC, CPMA, CEMC, CFPC, CPC-I, CCS-P, CMRS As a physician auditor, I spend much of my time educating clinicians on proper documentation. This involves explaining and interpreting coding and compliance guidelines. When providing such guidance, the most common reply I hear from providers is, “I want it in writing.” An auditing ...
In Billing
Oct 1st, 2010
Medicare no longer accepts 99241-99255, but other payers may. By Lindsey H. Daly, MSHA, CPC As I write this, it has been over six months since the Centers for Medicare & Medicaid Services (CMS) stopped accepting CPT® consultation codes 99241-99245 (outpatient) and 99251-99255 (inpatient); however, not all payers have followed suit. Many non-Medicare payers still ...
In CMS
Mar 12th, 2010
Since announcing that CPT® consultation codes (ranges 99241-99245 and 99251-99255) would no longer be recognized for Medicare Part B payment effective Jan. 1, the Centers for Medicare & Medicaid Services (CMS) has been bombarded with questions. In response, the agency has issued MLN Matters Special Edition article SE1010, entitled “Questions and Answers on Reporting Physician Consultation Serv...