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Ophthalmology and Optometry Coding Alert

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CMS Will Offer Modifier to Denote Admitting Physician on Claims

Published on Sat Oct 10, 2009

Consultation changes make it crucial to report hospital visits properly. Practices across the country are abuzz with the news that Medicare will stop covering consultations effective Jan. 1 -- but there are a few things every coder should know before that deadline hits. Important: Although Medicare will no longer pay for consultation codes (99241-99255), not all payers will necessarily follow suit. "The consultation codes have not been removed from CPT -- the AMA still printed them in the 2010 manual," notes Barbara J. Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions in Tinton Falls, N.J. "At this point, we don't know what other payers are going to do." Inpatient change: In the past, only the admitting physician reported initial hospital care codes (99221-99223), and specialists whose opinion and/or advice was sought would bill inpatient consultation codes. With the no-pay policy on consultation codes, CMS is poised to [...]
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