Internal Medicine Coding Alert

Use 2002 HCPCS and CPT codes (when appropriate) rather than new and revised 2003 codes to receive maximum reimbursement for January and February claims.

Medicare says it will hold all claims using 2003 codes until March 1 and pay for them at 2003 fee schedule rates. It will pay 2002 codes at the higher 2002 rates, however, as long as it processes the claims by Feb. 28.

Other third-party payers may follow Medicare's lead, so be sure to check with your other payers to determine if they will recognize the 2003 codes before March 1, says Sherry Wilkerson, RHIT, CCS, CCS-P, coding and compliance manager at Esse Health, a multispecialty practice in St. Louis.

If you must use a 2003 code for a service and you provide other services to the same patient that can be billed using 2002 codes, be sure to separate the claims, using different forms (electronic or paper) for the 2002 and 2003 codes.

"If you bill a combination of new and old codes, there's a strong likelihood Medicare will hold the whole claim until March 1," says Brett Baker, third-party payment specialist for the American College of Physicians-American Society of Internal Medicine (ACP-ASIM) in Washington, D.C.

If you bill the 2002 and 2003 codes on separate forms, however, Medicare will process the 2002 codes at 2002 reimbursement rates and hold only the 2003 claim until March. Some offices may find it easier to hold off using 2003 CPT and HCPCS codes until March 1 or to hold all claims for 2003 codes in their offices until March 1, Wilkerson says.