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new 2010 coding rules

  1. #1
    Location
    St. Louis, Missouri
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    262
    Default new 2010 coding rules
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    My physician was called to the hospital to do a consult on a Medicare patient. The patient had been in the hospital for a week already so we were not the admitting physician. We have never seen the patient before. I know that I can no longer use the consult code because the patient is Medicare. The new patient codes are for office or outpatient visit only. The initial hospital care code states that it is to be reported by the admitting physician. Does this mean I am only left with subsequent hospital care codes or am I missing something??

    Melissa Blow, CPC

  2. #2
    Location
    Dover Seacoast New Hampshire
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    For Medicare patients, use the initial hospital visit code. This is not specifically for admissions, under the new consultation guidelines for CMS.

  3. #3
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    Hi Melissa
    Here is the CMS med matters this should help clear things up for you
    My understanding is that if you are the consulting MD then you charge an initial visit (99221-99223)
    The attending MD must have an AI modifier on their initial visit
    Hope this helps
    Robin Ingalls-Fitzgerald CCS, CPC, FCS, CEMC, CEDC



    http://www.cms.hhs.gov/MLNMattersArt...ads/MM6740.pdf

  4. #4
    Default
    Quote Originally Posted by mmelcam View Post
    My physician was called to the hospital to do a consult on a Medicare patient. The patient had been in the hospital for a week already so we were not the admitting physician. We have never seen the patient before. I know that I can no longer use the consult code because the patient is Medicare. The new patient codes are for office or outpatient visit only. The initial hospital care code states that it is to be reported by the admitting physician. Does this mean I am only left with subsequent hospital care codes or am I missing something??
    Melissa,

    I found a great tool for coding consults for Medicare patients on the E&M University website. It's a big help for me, I hope it helps you too

    http://emuniversity.com/Consultalgo.pdf

  5. #5
    Location
    St. Louis, Missouri
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    262
    Default
    Thanks for the info....that really helped!!

    Melissa Blow, CPC

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