Wiki Medication Reconciliation 1111f

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We need some guidance on Bilateral billing guidelines for CPTs 20610,20611,20552,20553 for different payors.Can you pls provide some guidance on this?

mnuhfer04

Networker
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North Tonawanda, NY
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If a patient has recently seen a specialist and the provider documents that a medication reconciliation was done, is it appropriate to report code 1111f? I ask because when I have looked this code up it states "Medication Reconciliation After Discharge", but the patient was not in an inpatient setting.
Thanks!
 

SharonCollachi

True Blue
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Clovis, CA
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The short answer is NO.

Here is the long answer: INSTRUCTIONS: This measure is to be submitted at an outpatient visit occurring within 30 days of each inpatient facility discharge date during the performance period. This measure is appropriate for use in the ambulatory setting only. There is no diagnosis associated with this measure. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. This measure is not to be submitted unless a patient has been discharged from an inpatient facility within 30 days prior to the outpatient visit.
 

mnuhfer04

Networker
Messages
38
Location
North Tonawanda, NY
Best answers
0
The short answer is NO.

Here is the long answer: INSTRUCTIONS: This measure is to be submitted at an outpatient visit occurring within 30 days of each inpatient facility discharge date during the performance period. This measure is appropriate for use in the ambulatory setting only. There is no diagnosis associated with this measure. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. This measure is not to be submitted unless a patient has been discharged from an inpatient facility within 30 days prior to the outpatient visit.
Thank you, that makes more sense!
 
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