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consultation changes for 2010

  1. Default
    Exam Training Packages
    Quote Originally Posted by mitchellde View Post
    No, the service of a consultation is still a valid and recognized service. Read careful... it says that CMS considers the codes for consultation as invalid codes. You have clear instructions on how to bill tese services you cannot bill the patient with an ABN.
    so what codes are we to use for in patient consults by specialist 99222-99223? I do understand office codes new and f/u. any comments?

  2. Question E/M University
    E/M University has a presentation on Medicare and consult's free. I recommend everyone check it out.

    My question is....are the codes themselves going away?

  3. Default
    On 12/23/09 NGS is doing two teleconferences on the topic of 2010 Consultation Changes

    Check out the event calendar:

    There is no registration required.
    ~Ursula, CPC~

  4. #34
    Atlanta Perimeter Professional Coders
    The transmittal released as linked below gives the most information yet. (Make sure you have the revised version.) It includes the modifier AI and what you are supposed to bill in each scenario. When you read it, you really need to think of it as primary or admitting physician normal billing rules vs. secondary or consulting physician's new rules for billing consults. You are receiving an increase on your normal EM codes on the fee schedule. This is for all physicians including PCPs and specialists.

    Valerie Rock CPC ACS-EM

  5. Default
    For those of you that still have questions about the 2010 consultation changes - I urge you to attend the NGS teleconference this afternoon (2pm to 4 pm EST). Call 866-837-0303 ID: 48308077. I attended the one this morning - and it was great!!! And...they left lots of time at the end of their presentation to take questions.
    ~Ursula, CPC~

  6. #36
    North Carolina
    I have to admit...I'm beginning to believe this is going to be an easy transition for us. I had one lingering question that many were hesitate to answer. I contacted our Medicare medical director and received an immediate response. I'm starting to see the light at the end of the tunnel...

  7. Default
    I feel a lot more comfortable about what is expected from us especially since the call.

    There were many people concerned about the ramifications of the Admitting Physician forgetting the AI modifier (as was I) and wondering if that was going to affect the specialists that get called (dare I say 'consulted'?) in. They assured us that at this time, they have not been instructed of any edits (for the modifier) to implement for the new year.
    ~Ursula, CPC~

  8. #38
    Thumbs down Good One Susan, My Sentiments exactly!!!!
    Quote Originally Posted by apmc View Post

    So, Medicare decides to eliminate the Consult codes, ok- I guess we have to deal with this.
    So my questions are:
    1) What am I allowed to bill for doing the report that still needs to be done for the referring doc because even though we cannot BILL for a CONSULT, it will still BE a CONSULT? 99080? 99499?
    2) Since consults are typically more extensive are we going to be able to get paid for prolonged services codes (99354, 99356) or are they going to hold up the entire claim until we submit notes on every claim like what's been going on with our geriatrics physician?
    3) Finally, and most importantly, I've read more than enough on the ruling, how about giving us some final details on HOW we are going to be billing for Inpatient Consultations as Subsequent visits? Just stating that "we will create a modifier" does not help me. Telling me WHAT the modifier is and WHICH doc will use it and letting me know sooner than 2 weeks before this new ruling goes into effect......THAT would be helpful.

    And while I'm on a roll - how about giving us the final fee schedule details instead of just the RVU's which are a royal PITA to figure out. This way we can at least get a general idea of how much of a revenue loss this will be.

    Well now, I feel a little better now that I vented. If anybody has any insight, please share- it would be much appreciated.

    p.s.- oh and I can't wait for the other payors to "follow suit". Especially the ones who increase their required copays to specialists even though they do not pay any more that a GP. Now the insurance co's can make even MORE profits!

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