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Thread: 2010 proposed rule and consults

  1. #11
    Join Date
    Apr 2007
    Greenville, SC


    AAPC: Back to School
    That's great info about the modifier to be used by the attending physician. I was wondering how that would be differentiated...multiple admit codes by different physicians, possibly on differing dates...how confusing would that be to track?

  2. #12


    I think this is coming a little late in the year - aren't the CPT's already at the printers?

    I don't mind the consult codes, I hope they do not approve this. I work for a specialty group and we have a high percentage of our E&M reimbursement dependent on consultations.

  3. #13
    Join Date
    Apr 2007


    This does not affect CPT at this time. It would just be CMS(that we know of) that would no longer pay for consults but they would still be in the book.

    What has been fairly consistent over the years though is that CMS tends to lead the pack, where they go the rest usually follow. So the odds are, if CMS stops paying everyone else will too.

    The final rule should be out a week from today.

    Laura, CPC, CEMC

  4. #14
    Join Date
    Apr 2007
    Milwaukee WI

    Default Wouldn't it be easier ...

    Wouldn't it be easier if CMS just PAID the consult codes at the equivalent new patient or initial patient visit?

    But nobody asked me ...

    F Tessa Bartels, CPC, CEMC

  5. #15
    Join Date
    Apr 2007


    lol, easy, that will be the day! When did CMS ever want anything to be easy?

    I am certainly concerned about this everybody getting an intial charge on the inpaitient side. As of right now, if your provider is called in to take over a piece of the care they just get a subsequent care day. Are they going to qualify for an initial care day too? Is everyone going to use the admit codes the first time they see a patient since there won't be any consult guidelines to follow if they do away with them. The documentation is going to be a nightmare, they are so used to documenting less unless they do the admit...not looking forward to that part at all. But I will be glad to see the consults go.

    Laura, CPC, CEMC

  6. #16


    based on an article I read, there would be a new modifier created to use with the 99221 -99223 codes for inpatient hospital codes, to differentiate between the admitting physician and the consulting physician.

    And wouldn't this also entail re-wording the code descriptions for 99201 - 99205 and 99221 - 99223?

    I am really hoping that this won't happen this year. I don't know about anyone else's physicians, but my physicians will need a little longer to prepare and adjust to these changes. (Also, not looking forward to their response when they learn about the lost revenue this change will cause.)

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