What payers will pay for consultation codes? The specialty (pain management) that I code for still uses consultation codes. I am aware that as of 2012 consultation codes were no longer in effect. Please put me in the right direction to find out what I need to know? Thank you
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Wiki Consultation Codes - pain management
- Thread starter Mavra
- Start date
mitchellde
True Blue
most do not consider this a valid service any longer. You should check with the payers in your area as it varies greatly. Of course Medicare does not. Check your payers current fee schedules on line is one quick way, if the codes are on the fee schedule with a dollar amount then they will pay for those codes. Just be certain you are looking at a current fee schedule.
mhstrauss
True Blue
Agree with Debra, definitely check your fee schedules. All of our commercial payers are still accepting consult codes (in Louisiana), but I see many others posting from other parts of the country that their payers are not. Wish there was a little more consistency!!
maddismom
Guest
I'm confused by your statement that as of 2012 Consultation Codes were no longer in effect? What does that mean?
mitchellde
True Blue
it was actually 2010 and it means that Medicare has stated in the MCM that a consult is an invalid service and must be billed using non-consult codes. Many other commercial carriers have also adopted this policy. The codes are valid the service is not.
maddismom
Guest
Yes, I'm aware that Medicare quit accepting consult codes in 2010. The statement referred to consult codes "no longer being in effect" and referred to the year 2012 and nothing about Medicare. I'm really not that "challenged" and was just asking for clarification because the statement made no sense to me.
And there is so much bad information out there on these forums submitted by EVERYONE, I'm determined to make sure I understand the questions and answers thoroughly. I appreciate the clarification and thank you.
And there is so much bad information out there on these forums submitted by EVERYONE, I'm determined to make sure I understand the questions and answers thoroughly. I appreciate the clarification and thank you.