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Ophthalmology and Optometry Coding Alert

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CMS Proposes Scrapping Consult Code Payment

Published on Thu May 28, 2009

Plus: 21.5 percent cut looms for your services. Heavy pay cuts for your ophthalmologist's services could be on the horizon, according to the proposed Medicare Physician Fee Schedule, printed in the July 13 Federal Register. CMS is projecting a record 21.5 percent rate cut, and proposes halting payment for consult codes in 2010. Instead of reporting consult codes (for example, for hospital patients who develop ocular complications such as blurring or eye pain), you'd report new or established patient office visit or hospital care (E/M) codes for these services, and CMS would increase payments for the existing E/M codes. To determine the impact of this change, you'd have to compare the reimbursement from the new fee schedule office visit fees vs. the current office consult fees, as well as the new hospital visit E/M charges vs. the current hospital consult fees, says Quinten A. Buechner, MS, MDiv, CPC, ACS-FP/GI/PEDS, PCS, [...]
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