Based on the two options Medicare presented when a secondary carrier accepts the consult code and Medicare does not... I opted for billing the accepted Medicare code. I found it more cost effective to bill the code Medicare accepts and let it go thru to the 2nd carrier.
More and more insurance companies will not accept a handwritten change/correction on a claim so there is so much extra time and cost invested. In other instances, certain claims crossover from Medicare automatically and then you are dealing with that correction.
What I am recommending to doctors is to be more specific about their time with a patient so that they can bill ethically. For example, smoking cessation counseling, 50% of E/M visit counseling, prolonged service, overlooked procedures. Often, they lump everything into a consult when there is so much more. Fortunately, access to EMR documentation helps ensure coding is accurate.
I am finding out through trial and error, as well as reading every carrier newlsetter that crosses my desk, that payers are slowly beginning to follow Medicare's guidelines. So be careful.
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