APA Offers Advice on Coding for Medicare Consults
Abstract
APA Offers Advice on Coding for Medicare ConsultsAPA's Office of Healthcare Systems and Financing issues a reminder about the elimination of Medicare's consult codes but is working with CMS to resolve the issues raised by the new policy. Medicare no longer recognizes evaluation and management (E/M) consultation codes for Medicare Part B fee-for-service payment for services rendered after January 1, according to APA's Office of Healthcare Systems and Financing (OHSF). What psychiatrists formerly billed as an office consultation should now be billed as an office or other outpatient visit for the evaluation and management of a new patient (99201-99205). An inpatient consultation should now be coded using the initial hospital care codes (99221-99223, but see cautions noted below). A consultation in a nursing facility should now be coded using the initial nursing facility care codes (99304-99306). And, finally, any consultations done as a home service should be coded as a home visit for the evaluation and management of a new patient (99341-99345). Psychiatrists may still use 90801 (psychiatric diagnostic interview examination) for an initial patient visit.Although consulting psychiatrists are still expected to document appropriately and communicate their findings to the doctor who referred the patient, they are no