Advanced Search

Ob-Gyn Coding Alert

Reader questions:

Look for Criteria to Protect Your Consultant Hiring

Published on Tue Jan 19, 2010

Question: We have arranged a contract with an infertility specialist. He will be billing services under our tax ID number and is currently set up with the same taxonomy code. Can he bill a consultation from one of our ob-gyn physicians within the same practice or is it an established E/M code? New Mexico Subscriber Answer: First of all, Medicare will do away with consultations in 2010, but private payers may not. Many of them do apply Medicare rules which differ from CPT guidelines. Make sure you know the rules that apply before billing. Yes, he can bill a consultation (99241-99245, Office consultation for a new or established patient ...) provided he meets all of the criteria for billing such. Consider the following criteria: Either the requesting or receiving physician has documented the request in the patient's record. Both the requesting physician and the consultant clearly indicate the reason for [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Ob-Gyn Coding Alert

View All