Health Information Management

Coding corner: Cope with confusing Medicare consultation code payment changes

HIM Connection, January 26, 2010

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The start of the new year typically ushers in a multitude of code changes. But for 2010, Medicare made an important change in payment of E/M codes that many hospitals may have overlooked.

CMS finalized its proposal to stop paying for consultation codes (99251–99255 and 99241–99245), according to the 2010 Medicare Physician Fee Schedule final rule, published in the November 25, 2009, Federal Register.

“That is one sure way to resolve the problem of incorrect reporting of consultation codes,” says Peggy S. Blue, MPH, CPC, CCS-P, regulatory specialist at HCPro, Inc., in Marblehead, MA.
 
CMS did away with secondary consultations a few years ago because they were being misused and abused, says Mary Ritchie, RHIA, CCS, CCS-P, CPC, vice president of coding services and data quality at MPA Consulting, Inc., in Long Beach, CA. After that, it focused on education, trying to get physicians to understand the difference between a consultation and a visit, and a consultation and a transfer of care. 

Note: For more information, visit the HCPro Web site. Subscribers to Medical Records Briefing have access to this article in the February issue of the newsletter.



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