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No more consultation codes

  1. #1
    Default No more consultation codes
    Medical Coding Books
    As of 1-1-10 the outpatinet and inpatient consult codes will be eliminated. Do you know if docs will need to do consult letters to referring docs now that we are using new patient codes?

  2. #2
    This is part of the good news.

    No more consult codes means no more consult code requirements. For medicare these no longer exist so you don't have to have a requesting provider, you don't need a specific reason, you don't have to tell anyone what your opinion is anymore.

    Will most providers continue to send letters back to the primary, my guess is yes. My providers do that anyway now even when they aren't consults. But they won't have to.

    You will treat these just like any other new or established patients, no special documentation or reporting requirements.

    Laura, CPC, CEMC

  3. Default
    check out the "Medicare Regulations" discussion topic section. There is a lot of conversation in there about the recognition of the consult codes.

  4. Default
    Just a reminder, consult codes haven't disappeared, Medicare alone has chosen not to accept them anymore. Until you are told otherwise, your other payers will still be accepting these codes. In those cases, you still need to follow all of the consultation guidelines if billling for a consult.

    Lisi, CPC

  5. Default Modifer AN or A1
    Quote Originally Posted by psheppar View Post
    As of 1-1-10 the outpatinet and inpatient consult codes will be eliminated. Do you know if docs will need to do consult letters to referring docs now that we are using new patient codes?
    I am wondering if anyone has heard about what if any modifier will be used to indicate that a true consult visit occurred rather than just an initial hospital visit by the admitting physician? Does anyone know and have a reference. I have searched CMS and Cahaba and have not found anything. thanks!

  6. #6
    Milwaukee WI
    Default Modifier AI
    Modifier AI (NOT A1 ... second character is the capital letter I) will be used by the admitting physician.
    No other modifier will be required by any "consulting" physician.

    F Tessa Bartels, CPC, CEMC

  7. Default
    Where were you able to find that modifier and is there a site on Medicare where we can find out the latest information about the elimination of the consult codes?

    AKelly, CPC

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