Medicare Eliminates Consult Codes - What Now?

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One of the most important changes for Medicare billing recently is the elimination of payment for consultation codes. Your practice will have to adjust how you bill for these types of services or you will find a lot of denials.

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Just in case you have not had a opportunity to read the newly released fee program (just kidding, it is a lot to read), I have summarized the section on consulting codes below.

Here are the facts about this new ruling and the inherent impact on your practice.

1. Consultation codes 99241-99245 (outpatient/office) and 99251-99255 (inpatient) have been eliminated. Tele-health consultation G-codes (G0425-G0427) will not be eliminated.

2. Use codes for new (99201-99205) or established (99211-99215) patients to replace consultations in the office/outpatient setting.

3. Codes in the outpatient hospital setting (99221-99223) should be used to replace outpatient consultation codes (99251-99255), and for nursing installation consultations use codes (99304-99306).

4. To distinguish the dissimilarity in the middle of the admitting physician of article from the consultants for preliminary hospital outpatient and nursing installation admissions, Medicare will form a modifier. Check with your local carrier for more information.

5. Payments for all appraisal and management codes have been increased in an endeavor to offset the fees lost from the elimination of consultation codes.

An prominent note about market or incommunicable insurance. No data has been released by other third party payers about payment for consultation codes as of yet. However, if your outpatient has Medicare as a secondary payer, a decision will need to be made by the physician as to how you will article the consultation. Any consultation claim filed with a market insurer such as Blue Cross or Aetna who is primary using the eliminated consultation codes when Medicare is secondary would follow in a denial for the secondary claim by Medicare. In those instances where Medicare is secondary, you may want to reconsider using the new guidelines as stated above for reporting consultation codes.

One more note. If you have not updated your enrollment data with Medicare since November 2003, you must do so. Although enrolled in Medicare, many physicians who are eligible to refer Medicare beneficiaries to other Medicare providers or suppliers for services do not have current enrollment records in Medicare. A current enrollment article is one that is in the Medicare supplier enrollment, chain and ownership ideas (Pecos) and also contains the physician's national supplier identifier (Npi).

Follow these few easy guidelines and you should have no question being paid for consulting codes.

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