Medicare Compliance & Reimbursement
Many Insurers Still Accept Consult Codes
Question: Answer: Medicare discontinued recognition of the consult codes, which pay 40 percent more than other E/M codes that have comparable levels of history, physical exam and medical decision-making. If your Medicaid provider is following this policy, then use an E/M code (99201- 99215) for the visit and the appropriate V code for the preoperative exam (V72.81-V72.85). Listing the reason for the surgery as the primary code (and the V code as the secondary code) can be helpful with some payers. For instance, if your Medicaid program is not recognizing consultation codes, you might report 99213 for the visit, linked to V72.83 ( Note that consult codes do appear in CPT
Medicare Compliance & Reimbursement
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Many Insurers Still Accept Consult Codes
Question: An established patient who was about to undergo a tonsillectomy presented to our office [...]
