AAPC - Back to school
Page 2 of 4 FirstFirst 1234 LastLast
Results 11 to 20 of 38

Thread: consultation changes for 2010

  1. #11

    Default ER visits

    AAPC: Back to School
    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?

  2. #12
    Join Date
    Apr 2007
    North Carolina


    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.

  3. #13


    Quote Originally Posted by mm3290 View Post
    The information you are looking for regarding consultation codes for 2010 is located in the final rule published in the 11/25/2009 federal register. CMS is no longer reimbursing for the consultation codes, most likely other payors will follow suite. The consultation codes are still valid CPT codes. Hope this helps!

    You can find it on page 31-39. Hope that helps.

  4. #14

    Default Consultations


    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


  5. #15


    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.
    ~Ursula, CPC~

  6. #16
    Join Date
    Apr 2007
    Mountain Home, AR

    Default Consults

    Medicare in Arkansas has release the fee schedules. No consults are included on the fee schedule.

  7. #17
    Join Date
    Apr 2007
    Athens, Ga.


    Same in Georgia...

  8. #18


    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.

    to register:
    ~Ursula, CPC~

  9. #19


    Quote Originally Posted by asma_wagih View Post
    You can find the final ruling in the Federal Register, November 2009. These sort of things are always posted in there.




    Good Luck!
    thanks! LOL

  10. #20
    Join Date
    Apr 2007
    Charlotte, NC


    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.

    Any ideas?


Page 2 of 4 FirstFirst 1234 LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.