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Thread: consult question

  1. #1
    Join Date
    Apr 2007

    Question consult question

    AAPC: Back to School
    A question has been posed do you have to charge a conult or can you chose to charge a new patient or established patient charge. Since Medicare is no longer excepting conult codes my practice wants to stop billng them to all insurances and instead use only new patient or established is that acceptable or not since for non medicare a consult code would be the most accurate and also what if medicare is secondary then how do you bill?

  2. #2
    Join Date
    Apr 2007


    I would not stop billing the consults codes for non medicare patient's. the reimbursement is more on the consult codes and so far no other insurances have stopped paying for them. If it's medicare secondary I would apply the medicare rules.

  3. #3
    Join Date
    Apr 2007
    South Bend


    Hi there,

    Our group has decided to bill consult codes to non-Medicare payers. We also are going to bill consult codes when Medicare is secondary. Medicare has come out with a directive stating that you can either change the code when submitting to MSP or you may start out billing the nonconsult codes to primary and crosswalk it as normal to MSP.

    I think whenever talking about Medicare I should state that I am in Indiana and our Medicare carrier is NGS.

    Thank you,

  4. #4
    Join Date
    Apr 2007
    Evansville Indiana

    Default IN Medicaid

    Have you heard anything from Indiana Medicaid on their status of payment of consult codes?

  5. #5
    Join Date
    Apr 2007
    Lakeland, FL


    Our company is only billing consult codes to straight commerical payers. All others are being billed as new or est patients. Just remember the three year guideline for billing new patient codes.

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