How will Medicare handle claims with the consultation codes for services rendered on or after January 1, 2010?
Effective January 1, 2010, Medicare contractors will deny and return claims for consultation codes 99241-99245 and 99251-99255 with a message indicating that Medicare uses another code for the services. If a patient is referred to your office for a consultation, you are now required to report an Evaluation and Management (E/M) code for a new or established office visit (99201-99215) that most appropriately describes the level of service provided. For consultation services provided in a hospital inpatient setting or nursing facility, you must report an E/M code for initial hospital care (99221-99223) that most appropriately describes the level of service provided.
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