Wiki new 2010 coding rules

[mmelcam]

My physician was called to the hospital to do a consult on a Medicare patient. The patient had been in the hospital for a week already so we were not the admitting physician. We have never seen the patient before. I know that I can no longer use the consult code because the patient is Medicare. The new patient codes are for office or outpatient visit only. The initial hospital care code states that it is to be reported by the admitting physician. Does this mean I am only left with subsequent hospital care codes or am I missing something??

 

[Pam Warren]

For Medicare patients, use the initial hospital visit code. This is not specifically for admissions, under the new consultation guidelines for CMS.

 

[ringalls]

Hi Melissa
Here is the CMS med matters this should help clear things up for you
My understanding is that if you are the consulting MD then you charge an initial visit (99221-99223)
The attending MD must have an AI modifier on their initial visit
Hope this helps
Robin Ingalls-Fitzgerald CCS, CPC, FCS, CEMC, CEDC



http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6740.pdf

 

[LTibbetts]

My physician was called to the hospital to do a consult on a Medicare patient. The patient had been in the hospital for a week already so we were not the admitting physician. We have never seen the patient before. I know that I can no longer use the consult code because the patient is Medicare. The new patient codes are for office or outpatient visit only. The initial hospital care code states that it is to be reported by the admitting physician. Does this mean I am only left with subsequent hospital care codes or am I missing something??

Melissa,

I found a great tool for coding consults for Medicare patients on the E&M University website. It's a big help for me, I hope it helps you too

http://emuniversity.com/Consultalgo.pdf

 

[mmelcam]

Thanks for the info....that really helped!!