AMA Symposium Report: Low-Level Consult Reporting in 2010

November 18, 2009

Dawn in Chicago. And a new day for consult coding.

Dawn in Chicago. And a new day for consult coding.

Hey, Coding News readers! It’s your turn to weigh in on the consult controversy.

Question: What should you do for Medicare 2010 coding if an inpatient consult on a patient’s initial hospital day does not support 99221?

Answer: Kenneth Simon, MD, MBA, FACS, CMS, senior medical officer at the CPT symposium was very adamant that you would have to use 99221. When questioners kept asking “But how could you use 99221 if the documentation didn’t support that level?” he continued to say, “On day 1, use 99221-99223.” His blunt repetition angered many attendees.

Ken, however, based his idea on data that Medicare used for the consult elimination that indicated most consult are coded as high-level consult. Therefore, he seemed to think the low levels would not be problematic.

How many of you currently are using low level consults (99251, 99252)? Let us know in a reply to this question.

Related articles:

Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report…
CMS at AMA Chicago: We’re Reducing Consult Request RequirementCMS auditors will look for 1 less thing in consult…
OK to Code Debridement With Consult?Question: Can you charge for an inpatient consult and a bedside…

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