drwilkins
New
One of my physicians would like to start billing for consultations. I am having trouble finding reliable coding guidelines. HELP!!:
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Wiki Consultation billing
- Thread starter drwilkins
- Start date
lflocca1
New
Consultation Billing
Look up Medicare's Internet Only Manual (IOM)
CMS IOM 100-4, Chpt 12, section 30 ? Correct Coding Policy,
Sections:
30.6 ? Evaluation and Management Service Codes
30.6.5 ? Physician in Group Practice
30.6.6 ? Payment for E/M services Provided During Global Period of Surgery
30.6.6 ? Payment for Office or Other Outpatient E/M Visits
30.6.10 ? Consultation Services
http://www.cms.gov/Regulations-and-...12.html?DLPage=1&DLSort=0&DLSortDir=ascending
Depending on if they are the Attending or the Consultant will determine if they use the Modifier -"AI".
Since January 1, 2010 CMS no longer recognizes Consultation CPT-4 Codes. They instruct to use Inpatient Initial or Subsequent CPT codes or Outpatient 99201 - 99215 depending on the status of the patient (IPD or OPD),
New-vs-Estab, and location.
Lisa Floccari, CPC, CPC-H
Look up Medicare's Internet Only Manual (IOM)
CMS IOM 100-4, Chpt 12, section 30 ? Correct Coding Policy,
Sections:
30.6 ? Evaluation and Management Service Codes
30.6.5 ? Physician in Group Practice
30.6.6 ? Payment for E/M services Provided During Global Period of Surgery
30.6.6 ? Payment for Office or Other Outpatient E/M Visits
30.6.10 ? Consultation Services
http://www.cms.gov/Regulations-and-...12.html?DLPage=1&DLSort=0&DLSortDir=ascending
Depending on if they are the Attending or the Consultant will determine if they use the Modifier -"AI".
Since January 1, 2010 CMS no longer recognizes Consultation CPT-4 Codes. They instruct to use Inpatient Initial or Subsequent CPT codes or Outpatient 99201 - 99215 depending on the status of the patient (IPD or OPD),
New-vs-Estab, and location.
Lisa Floccari, CPC, CPC-H
RebeccaCross*
Guest
There are still other carriers that pay for consults...
drwilkins
New
Thank you!!