Monday, December 21, 2009

Consultation Changes for 2010

Happy Holidays... Not much may change for me here in Idaho, but in the world of coding... things are changing fast and furious..... Below is a quick "down and dirty" of the changes that are on the horizon for the 2010 consultations. This came to me by way of Gail Eldridge (Coding Goddess extraordinaire!) so I am sharing with all of my Blogging friends! E-mail me if you have ??'s or concerns... networking is one of the best ways to problem solve!!! Enjoy your holiday and keep on coding!

What's Coming for Consultations in 2010

There are some major changes to inpatient consultation codes coming Jan.1st, 2010. Unfortunately I still have unclear guidance on exactly what the changes will mean to you. Stay tuned next month for more information

What we do know

- As of January 1st, 2010 Medicare will no longer pay for the inpatient or outpatient consultation codes (99241-99245 and 99251-99255)

- Outpatient consultations will be billed with the new patient E&M codes (99201-99205)

- Inpatient consultations will be billed with either an Initial hospital Care code(99221-99223) or a subsequent hospital care code (99231-99233)

- Medicare will now pay for more than 1 provider to bill the Initial hospital care code (99221-99223) multiple specialties will now be able to bill this code

- An unknown modifier will need to be appended to the Initial hospital care code(99221-99223) of the admitting physician

- Work RVU values will be increased for new patient E&M codes (99201-99205) and Initial hospital and subsequent hospital care codes (99221-99223 and 99231-99233)

- The 2010 CPT description of the consultation codes actually loosens the language of when you can bill a consultation. New language states "recommend care or assume ongoing management" it also states that the request for the consult can now be documented by the requesting or the rendering provider

- Telemedicine consultations will still be paid with the appropriate G-Codes

What we don't know- We have no idea which other payors will be paying for these codes if any or what RVU value will be assigned. It is suspected that several Idaho payors may continue to allow use of the inpatient and outpatient consultation codes

- The only payor that has announced they will pay for the consultation code set is on the east coast with no active members in Idaho

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