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This is why consults are going away...lol

  1. #1
    Default This is why consults are going away...lol
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    As many of you know from previous posts one of my departments utilizes an external coding company that doesn't seem to believe in following any known guidelines. Yesterday we had a meeting with them regarding inpatient E/M services that do not meet the requirements for consult codes. They refused to assign anything other than a consult code unless we signed a waiver. Below is a copy of the waiver, minus company names.

    "Specific Coding Disclaimer
    For
    (Inpatient consults with no referring listed in documentation)

    Billing and Coding Service a.k.a. B&C, Inc. does not represent or endorse the accuracy or reliability of coding for the specific CPT codes of 99231 - 99233 which are daily care codes to be used for inpatient consults with no referring physician listed in the documentation. Health System accepts responsibility for providing documentation to support such coding in the event of an external audit, and releases B&C, Inc. from such responsibility. This disclaimer does not affect the relationship or contract between B&C, Inc and the Health System with regard to any other coding issues. "

    Obviously this will change a good bit next year (most of this practice is Medicare) but for now, we are signing the waiver. I could be wrong, if I am please someone post the backup, but I am not aware of anyone getting in trouble for not billing a consult code when the requirements are not met.

    Obviously if there is no requesting provider listed no report made it back, but these are clear transfers of care in every way. They just get dictated on a header that says "consult".

    Anyway, got a kick out of that one thought I would share.

    Laura, CPC, CEMC

  2. #2
    Location
    Columbia, MO
    Posts
    12,570
    Default
    And yet your company still uses this service. That I find amusing!

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default No doubt, I shake my head in wonder everyday!
    It is only because of the doctors, everyone else is trying to get rid of them. The doctors threaten to walk if we stop using them. It is messed up on many levels.....maybe we will have more luck next year.

    Laura, CPC, CEMC

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    I would frame that one!
    Lisa Bledsoe, CPC, CPMA

  5. #5
    Location
    Columbia, MO
    Posts
    12,570
    Default
    Now that is messed up! Do the physicians have a vested interest in this company? As in a friend owns it or they have a percent interest? It is just way bad (ignorant?) on their part to ignor the importance and the implications of continuing with this type of service. Good Luck to you! Merry Christmas and a Happy New Year to You!

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
    Default
    Hi Laura:

    This is hilarious indeed. Basically you sign a waiver to not hold them responsible for not doing it wrong. LOL

    I would be concerned as to why these docs are so committed to the company, as Mitchellde pointed out - do they have some sort of interest? Wouldn't that create a possible compliance risk? What's their reasoning?

    Hopefully they just like the service for whatever not-so-logical reason.

    Anyway best wishes to all for the end of year festivities.
    Karolina, CPC, CPMA, CEMC

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