Wiki Consultation coding

[LMOuellette]

Good Morning, I am in desperate need of some assistance. I am currently a coding student, however I have been billing/coding for about 5 years. It is my understanding that consultation codes are invalid and have been since 2012. However according to my coding instructor this only applies to medicare. Can any confirm or deny this information? Thank you in advance

 

[mhstrauss]

Good Morning, I am in desperate need of some assistance. I am currently a coding student, however I have been billing/coding for about 5 years. It is my understanding that consultation codes are invalid and have been since 2012. However according to my coding instructor this only applies to medicare. Can any confirm or deny this information? Thank you in advance

Your instructor is correct. "Consultation" E/M codes (99241-99245, 99251-99255) are still valid codes found in the current CPT book. MEDICARE, and a lot of other government payers, and some commercial payers, chose to stop allowing these codes several years ago (I believe as of 2010) because this codeset was often misused. Each payer should have their policy stating whether or not they continue to accecpt Consultation codes in writing.

Hope this helps!