General Surgery Coding Alert

Only shrewd payment calculation can salvage lost pay.As if it's not confusing enough using consultation codes for one payer and inpatient/outpatient codes for another -- what if one patient has two insurance payers? That's the dilemma you'll face for Medicare Secondary Payer (MSP) claims.Study our experts' advice to see how you can manage this latest consultation coding quandary for your general surgery practice.Know the Extent of Your ProblemIf a patient has Medicare as secondary insurance and you bill a consultation (99241-99255, Office/Inpatient consultation for new or established patient), you won't see the supplemental pay because Medicare no longer recognizes the codes, points out Marvel Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, owner of MJH Consulting in Denver. "The issue becomes somewhat problematic if the primary insurance leaves a patient balance (such as coinsurance or a deductible) and the service needs to be reported to Medicare," Hammer says.Inventory your major payers: To [...]