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Thread: Medicare Down Coding

  1. #1

    Default Medicare Down Coding

    AAPC: Back to School
    We have had several request from Pinnacle, CMS, for copies of our Ortho Consults, which CMS then down codes from a consult to 99202, then we are paid the lower reimbursiment. We have good documentation. Is any one else having this problems with Medicare?
    Brenda Lewing, LPN, CPC

  2. #2
    Join Date
    Apr 2007


    are you certain these are consults and not transfer of care?

  3. #3


    yep, one was ER consult request from primary care and others were seen in our office at the request for consult from primary care physician

  4. #4
    Join Date
    Apr 2007
    Greeley, Colorado


    Did the documentation meet the consultation requirements - Request/Render/Report?
    Lisa Bledsoe, CPC, CPMA

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