As many of you know from previous posts one of my departments utilizes an external coding company that doesn't seem to believe in following any known guidelines. Yesterday we had a meeting with them regarding inpatient E/M services that do not meet the requirements for consult codes. They refused to assign anything other than a consult code unless we signed a waiver. Below is a copy of the waiver, minus company names.
"Specific Coding Disclaimer
For
(Inpatient consults with no referring listed in documentation)
Billing and Coding Service a.k.a. B&C, Inc. does not represent or endorse the accuracy or reliability of coding for the specific CPT codes of 99231 - 99233 which are daily care codes to be used for inpatient consults with no referring physician listed in the documentation. Health System accepts responsibility for providing documentation to support such coding in the event of an external audit, and releases B&C, Inc. from such responsibility. This disclaimer does not affect the relationship or contract between B&C, Inc and the Health System with regard to any other coding issues. "
Obviously this will change a good bit next year (most of this practice is Medicare) but for now, we are signing the waiver. I could be wrong, if I am please someone post the backup, but I am not aware of anyone getting in trouble for not billing a consult code when the requirements are not met.
Obviously if there is no requesting provider listed no report made it back, but these are clear transfers of care in every way. They just get dictated on a header that says "consult".
Anyway, got a kick out of that one thought I would share.
Laura, CPC, CEMC
"Specific Coding Disclaimer
For
(Inpatient consults with no referring listed in documentation)
Billing and Coding Service a.k.a. B&C, Inc. does not represent or endorse the accuracy or reliability of coding for the specific CPT codes of 99231 - 99233 which are daily care codes to be used for inpatient consults with no referring physician listed in the documentation. Health System accepts responsibility for providing documentation to support such coding in the event of an external audit, and releases B&C, Inc. from such responsibility. This disclaimer does not affect the relationship or contract between B&C, Inc and the Health System with regard to any other coding issues. "
Obviously this will change a good bit next year (most of this practice is Medicare) but for now, we are signing the waiver. I could be wrong, if I am please someone post the backup, but I am not aware of anyone getting in trouble for not billing a consult code when the requirements are not met.
Obviously if there is no requesting provider listed no report made it back, but these are clear transfers of care in every way. They just get dictated on a header that says "consult".
Anyway, got a kick out of that one thought I would share.
Laura, CPC, CEMC