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Ophthalmology and Optometry Coding Alert

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CMS to Issue More Guidance on Consult Code Replacements

Published on Sun Jan 24, 2010

Best bet: Follow local guidance until more detailed info comes from Medicare. If you've been confused about how to report low-level hospital visits now that consult codes are gone, you aren't alone. CMS intends to tackle this problem by issuing more specific guidance on the topic in the near future. That's according to a Feb. 2 CMS-sponsored Physicians, Nurses, and Allied Health Professionals Open Door Forum, where one practice asked the CMS reps when the agency plans to issue instructions on how to report initial hospital visits when the documentation doesn't meet the criteria for the lowest level visit, a 99221. CMS is currently working with the medical community to create such guidance, which will "hopefully be out shortly," noted CMS's Whitney May during the call. One caller indicated that her MAC (WPS Medicare) instructed her to use the unlisted E/M code 99499 when the visit doesn't meet the criteria [...]
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