subject: Consultations Medicare 2010 - Nix The Confusions [print this page] CMS is halting payment for in-office consultation codes and inpatient consultation codes in 2010. But the AMA has decided not to delete them, keeping them in the CPT manual for another year.
Consult codes appear in CPT 2010 codes, but that does not mean payers will cover the services this year. Medicare published the final rule on the fee schedule and adopted the proposal to no longer pay for the consultation codes. Private payers might also toe the line and eliminate consultation payment.
Till date, Medicare is the only payer that has decided not to pay consultations. Some payers are keeping a watchful eye and will do accordingly. But all this said and done, the codes as defined in the CPT book will still have to be utilized according to CPT regulations. Its just that for Medicare, one has to ignore the consultation rules and regulations.
According to some, the problem is that the elimination is only a CMS issue and not a private payer elimination. Each payer will decide whether to adopt Medicares rule or not. The AMA has in fact, as mentioned above, kept consultations in the CPT manual. And if you thought getting a request for opinion was difficult before, this will be worse since no one knows who will require one, with the only surety being that CMS does not.
With all the confusion surrounding Consultations Medicare 2010, its very important that you have a reliable source of information to tide you through this initial phase of consultation confusion. For this, help is close at hand in the form of one-stop medical coding websites. So whether its the final rule or other consult code updates, youll soon get a clear picture when you sign up for one.
