Wiki Tricare Consult codes

jewlz0879

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I've done some research and I see that the MHS (Military Health System) no longer covers Consult codes (99241-99245 and 99251-99255). Is Tricare governed by MHS? We have a manager saying that Tricare does not follow CMS guidelines and we can bill consult codes, yet this is causing a problem. By Federal Law, Tricare must be the 2ndary payer with all healthacare plans except for Medicaid, IHS and Tricare supplements.

So when we bill 99222, since Medicare is primary, and another physician has already billed that to Tricare, they are denying. We crosswalk and that is where the stink comes in from this manager.

I am having a hard time finding any solid information on this. Are there any Coding/AR guru's out there on Tricare?

This manager says we can bill consults to Tricare.

Any help, information on this topic is greatly appreciated!

Best,
 
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