Summer
Networker
Good morning everyone,
I read an interesting article where it spoke about shared/split services and consults - I truly understand the guidelines however this tid bit stood out since I've not seen it written as such in anything that I've read until today.
Let me share, although the codes have technically changed for submitting consults to government payors, the consult guidelines have remained the same in the CMS manual. As a result, the actual service (of a consult) cannot be shared per CMS even thought the CPT's shifted to the 99221-99223 (Initial IP Admit) series. Dependent on where you are located, I'd check with your local MAC as they do have some discretion regarding the guideline interpretation. I would also encourage your providers to bill based on who provided the consult (NP, PA or MD) even thought you are billing with the initial IP admit codes for example until these guidelines are crystal clear.
If I'm understanding this correctly - correct?
Have a great morning!
I read an interesting article where it spoke about shared/split services and consults - I truly understand the guidelines however this tid bit stood out since I've not seen it written as such in anything that I've read until today.
Let me share, although the codes have technically changed for submitting consults to government payors, the consult guidelines have remained the same in the CMS manual. As a result, the actual service (of a consult) cannot be shared per CMS even thought the CPT's shifted to the 99221-99223 (Initial IP Admit) series. Dependent on where you are located, I'd check with your local MAC as they do have some discretion regarding the guideline interpretation. I would also encourage your providers to bill based on who provided the consult (NP, PA or MD) even thought you are billing with the initial IP admit codes for example until these guidelines are crystal clear.
If I'm understanding this correctly - correct?
Have a great morning!