Wiki Billing for a 99245 instead of E/M code

[dedwards1006]

Has anyone heard of billing the 99245 code for Medicaid patients referred to our office by another physician over the E/M code for better reimbursement? I always thought the Consult codes were paid less than the E/M code.
If anyone has any insight on this that would be great!
Thank you in advance.

 

[mitchellde]

Consult codes overall pay better, However, most carriers no longer accept consultation codes and refer you to Medicare alternative consultation coding which means you use an office visit level for and office visit consultation. so the first question is, does your state Medicaid accept consultation codes, if so then the next question would be, has the service rendered met the three basic requirements for a consultation, and the last question is have you met the requirements for the level 5.

 

[dedwards1006]

Thank you for your response our state medicaid does allow billing of consult codes but from what we can see it would be hard to meet a level 5 visit as we are a dermatology office. With more research we have found the E/M code to be better for our office.
Again, Thank you for your response.