Some physician practices billing consultation codes (99241-99245, 99251-99255) to private payers running Medicare Advantage plans have recently reported receiving denials.
After CMS eliminated the codes Jan. 1, private payers could choose to continue reimbursing the codes or follow CMS's lead.
At first, most continued accepting the codes. But practice management consultants recommended that practices try to keep up with policy updates from payers contracted with the practice. Several payers - such as Humana, UnitedHealthcare and Anthem (pdfs) - have since said they will no longer accept consult codes.
Practices also must monitor denials. Receiving a denial for using a consult code is another way to learn a payer no longer accepts the codes (although it's finding out the hard way).
Have you come across private payers no longer taking consult codes? If so, who?