Prepare for Private Payer Consult Coding Differences
Published on Fri Nov 27, 2009
Come Jan. 1, you may have multiple ways of reporting your doctor's services. CPT Codes did not eliminate the consultation codes, which could be troublesome for your coding know-how. "CPT still recognizes the codes, and they will be in the 2010 CPT book," says Leah Gross, CPC, coding lead at Metro Urology in St. Paul, Minn. "Medicare is just not recognizing them. So far, we haven't been able to get word from any other insurance," she adds. Some large payers and perhaps also small payers that do not base their fee schedules on Medicare's fee schedule may not follow Medicare's lead. As of mid-December, directives still remain unsettled. The potential for differing rules between CMS and private payers, could spell trouble. "We are going into Dante's Inferno for 2010," says Barbara J. Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions and Senior Coder and Auditor for [...]