TITLE

Consultation Code Confusion

AUTHOR(S)
Tomkins, Julia E.
PUB. DATE
March 2010
SOURCE
Journal of Oncology Practice;Mar2010, Vol. 6 Issue 2, p102
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The article explores the changes of the coverage of consultation codes by the U.S. Centers for Medicare & Medicaid Services (CMS) which were implemented on January 1, 2010. It scrutinizes the Medicare coverage rules regarding consultations and issues such as Medicare as a secondary payer and how the Medicare coverage change can be handled by private payers. It presents a summary of the coding instructions by the CMS in specific settings such as hospital setting for first time visits, hospital setting for subsequent visits and nursing facility first time visit. It mentions two options from the 2010 policy of the CMS as a secondary payer for claims submitted to a primary payer who continues to recognize the consultation codes which includes billing the initial care codes or care codes.
ACCESSION #
48590035

 

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