AAPC - Back to school
Results 1 to 4 of 4

Thread: no consults allowed!

  1. #1
    Join Date
    Apr 2007
    Kansas City AAPC

    Default no consults allowed!

    AAPC: Back to School
    Consult codes are gone so my podiatrist is using the initial hospital care code 99223 in it's place. Now we are getting denials because in MO a podiatrist cannot admit a patient. This is not an admission. Anyone else having this problem? Any ideas on how to solve it?

  2. #2
    Join Date
    Apr 2007
    Cape Girardeau


    In Missouri the only codes allowed for a podiatrist is 99231, 99232 which are subsequent visits, 99234, 99235 for observations, and 99238 for discharge. I appealed my admissions and even went to the 2nd level of appeal to no avail. These are the only codes allowed. What makes not sense to me is they can discharge, but not admit.

  3. #3
    Join Date
    Apr 2007
    Kansas City AAPC

    Default still no consults!

    Thanks for your comment. Maybe I should encourage my doc to move to Kansas! Were these Medicare denials?
    Last edited by PamBorden; 04-20-2010 at 04:09 PM. Reason: additional question.

  4. #4
    Join Date
    Apr 2007
    Dover Seacoast New Hampshire


    You're right, Pam, 99211-99223 are not specifically "admissions". By definition, they are 'initial inpatient visits'. As such, they should be billable according to CMS's new rule, but remember who we're dealing with!! LOL

    I'd contact your CMS contractor to see what they specifically recommend for your specialty. Let us know what you find out, please.
    Pam Brooks, MHA, CPC, PCS, COC
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

Similar Threads

  1. Consult allowed??
    By rjenn86 in forum E/M
    Replies: 1
    Last Post: 04-30-2013, 03:01 PM
  2. Allowed Codes
    By AmandaM2153 in forum Medicare Regulations
    Replies: 5
    Last Post: 11-12-2012, 08:59 AM
  3. Who is allowed to do a 99211??
    By kerrlau in forum Billing/Reimbursement
    Replies: 4
    Last Post: 04-23-2012, 03:59 PM
  4. Billed Less Than Allowed
    By ladonnaalexis in forum Billing/Reimbursement
    Replies: 2
    Last Post: 05-08-2010, 03:26 PM

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.