lmcreynolds@aoamail.net
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Hello.
Has anyone noticed an increase in United Healthcare denials when billing 99221 or 99222? I work for an Orthopedic group. When we are on call, we receive many hospital physicians requesting us to consult on patients who have been admitted. Depending on the level of service, we bill 99221, 99222 or 99223 for our ortho physicians' consultations for patients with Medicare or Medicare products.
While reviewing the guidelines for Inpatient Consultations, we found "only one consultation may be reported by a consultant per admission". Does that mean "only 1 physician can bill a 9922- series codes" for that admission? Or does it mean "only one consultation per specialty"? If one per specialty, we are thinking that the admitting physician is not reporting their consult with the AI modifier.
Any help or insight on this matter would be greatly appreciated. Thank you.
Has anyone noticed an increase in United Healthcare denials when billing 99221 or 99222? I work for an Orthopedic group. When we are on call, we receive many hospital physicians requesting us to consult on patients who have been admitted. Depending on the level of service, we bill 99221, 99222 or 99223 for our ortho physicians' consultations for patients with Medicare or Medicare products.
While reviewing the guidelines for Inpatient Consultations, we found "only one consultation may be reported by a consultant per admission". Does that mean "only 1 physician can bill a 9922- series codes" for that admission? Or does it mean "only one consultation per specialty"? If one per specialty, we are thinking that the admitting physician is not reporting their consult with the AI modifier.
Any help or insight on this matter would be greatly appreciated. Thank you.