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no consults allowed!

  1. #1
    Location
    Kansas City AAPC
    Posts
    9
    Default no consults allowed!
    Medical Coding Books
    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
    Location
    Cape Girardeau
    Posts
    44
    Default
    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
    Location
    Kansas City AAPC
    Posts
    9
    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
    Location
    Dover Seacoast New Hampshire
    Posts
    2,016
    Default
    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, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

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

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