However, they should be reported if a decision to accept transfer of care can't be made . The health plan will identify consultation codes 99241-99255 and crosswalk them to the more appropriate level of office visit, established patient or subsequent hospital care procedure code. Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role. endobj 0000001415 00000 n If the initial inpatient or observation care service is a consultation service the consultant should report subsequent hospital inpatient or observation care codes 99231-99233. . Only the preventive medicine E/M service code, reported with ICD-10 codes . Thanks for your help, Copyright 2023, AAPC <> In the past, the codes 99221-99223 were used only for the admitting physicians, and the codes 99251-99255 were . In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. endobj Copyright 2023, CodingIntel 0000004127 00000 n Are consultation codes obsolete? - ACAAI Member 2. Watch out with BCBS especially because if you code an initial hospital visit when it was actually a consult (as is the common practice with any other payer), they will recoup their payment and you'll have to resubmit a corrected claim. CPT guidelines state that only one inpatient consult code should be reported by a consultant per admission. endobj I dont have an answer to give them because I am getting a lot of conflicting info. Privacy Policy | Terms & Conditions | Contact Us. If you pass the claim on to the MSP using the consult code, the . endobj We maintain and annually update a List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes (the Code List), which identifies all the items and services included within certain designated health services (DHS) categories or that may qualify for certain exceptions. So how do we bill these consult codes? I wonder if our doctors will ever get back to being able to practice medicine and not insurance OR law? 0000012036 00000 n Payment policies and rules | Blue Shield of CA Provider %PDF-1.7 % We are looking for thought leaders to contribute content to AAPCs Knowledge Center. 0000007877 00000 n It's been nearly a decade since Medicare has accepted claims for either outpatient (99241-99245) or inpatient (99251-99255) consultations. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise.
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