Wiki no consults allowed!

[PamBorden]

Consult codes are gone so my podiatrist is using the initial hospital care code 99223 in it's place. Now we are getting denials because in MO a podiatrist cannot admit a patient. This is not an admission. Anyone else having this problem? Any ideas on how to solve it?

 

[belindapearl]

In Missouri the only codes allowed for a podiatrist is 99231, 99232 which are subsequent visits, 99234, 99235 for observations, and 99238 for discharge. I appealed my admissions and even went to the 2nd level of appeal to no avail. These are the only codes allowed. What makes not sense to me is they can discharge, but not admit.

 

[PamBorden]

still no consults!

Thanks for your comment. Maybe I should encourage my doc to move to Kansas! Were these Medicare denials?

 

[Pam Warren]

You're right, Pam, 99211-99223 are not specifically "admissions". By definition, they are 'initial inpatient visits'. As such, they should be billable according to CMS's new rule, but remember who we're dealing with!! LOL

I'd contact your CMS contractor to see what they specifically recommend for your specialty. Let us know what you find out, please.