Does anyone know how to bill an ER visit for a Medicare patient in 2010, if the visit previously met the criteria to be billed as a consult how should it now be billed?
The proposed crosswalk is 99201-99215. However, there is still an open issue with 99281-99285 since the current rule allows...
Emergency Department Physician Requests Another Physician to See the Patient in Emergency Department or Office/Outpatient Setting
If the emergency department physician requests that another physician evaluate a given patient, the other physician should bill a consultation if the criteria for consultation are met. If the criteria for a consultation are not met and the patient is discharged from the Emergency Department or admitted to the hospital by another physician, the physician contacted by the Emergency Department physician should bill an emergency department visit. If the consulted physician admits the patient to the hospital and the criteria for a consultation are not met, he/she should bill an initial hospital care code.
Since 99284 carries 2.56 RVU's and 99204 (assuming they are new) carries 2.30 RVU's, I could see physicians preferring the ER CPT codes.
Are you all sure consultations are going away after this year. I just spoke with a representative for Medicare Trailblazer (Oklahoma, Texas, New Mexico, and Colorado). He said that nothing had been finalized at this time and that consults were still going to be valid next year as of right now. He said Medicare was primarily focused on fine tuning the fee schedule at this time and may or may not finalize their plans for consultations. I have explored the links provided by everybody, but I found his comments very interesting
Several of the Medicare contractors have told me that they just have not received their finalized instructions from CMS and are still awaiting that before passing on any information regarding the consultations.
Medicare in Arkansas has release the fee schedules. No consults are included on the fee schedule.
Highmark Medicare is having a webinar on 12/22/09 on the topic "in-hospital visits". It might be interesting to attend and ask questions.
Originally Posted by asma_wagih
How are split/shared visits going to be looked at now for Inpatient?
We had a webinar in our office last Friday (but it took place earlier so we couldn't ask questions) that shows on one of the slides "Split/shared visits look to be allowed now". This is for MD's and mid-levels.