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Wiki Medicare Down Coding

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brendalewing

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Local Chapter Officer
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29
Location
Many, LA
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We have had several request from Pinnacle, CMS, for copies of our Ortho Consults, which CMS then down codes from a consult to 99202, then we are paid the lower reimbursiment. We have good documentation. Is any one else having this problems with Medicare?
Thanks,
Brenda Lewing, LPN, CPC
 
yep, one was ER consult request from primary care and others were seen in our office at the request for consult from primary care physician
 
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