Part B Insider (Multispecialty) Coding Alert
E/M and Inpatient Visits, Consults Hit Hard by 2004 RVU Changes
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Among the dozens of CPT Codes targeted for cutbacks in the 2004 fee schedule are 46 codes that begin with 99, according to a chart in the new final regulation.
The 4.5 percent cut, combined with some adjustments to RVUs, has resulted in a sledgehammer hit to evaluation and management codes, inpatient visit codes, and consult codes, among others. Hardest hit will be high-level E/M codes for new patients (99205) and existing patients (99215), which will drop 4 percent each.
Nursing facility (99301-99303) and home visits (99348 and 99350) will drop 5 percent each.
Physicians will actually see an increase in the first hour of critical care (99291) in the inpatient setting, from $210.05 to $229.07. But the next half-hour of critical care (99292) will drop from $107.78 to $101.19 to compensate.
Treatment of retinal lesion (67210) will drop from $604.59 to $544.58. Also, upper GI endoscopy (43239) will drop from $337.69 to $305.31, and lesion-removal colonoscopy (45385) will drop from $545.53 to $471.85. Destruction of a benign or premalignant lesion (17000) will drop from $61.43 to $57.27.
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