The presentation slides from the CPT Annual Advisors Meeting in October have been posted up on the AMA's website. I found them while looking for information on the new modifier 33, which is not available as of this posting.
During the meeting, the AMA gave a presentation on consultation codes (pdf). CMS discontinued consult billing in the Medicare program in 2010. The AMA and other physician groups lobbied CMS to change course, but CMS has not yet relented.
A few presentation slides by Peter Hollmann, MD, the vice-chair of CPT's Editorial Panel, show the billing confusion caused by eliminating consults. Consult codes don't evenly crosswalk to the E/M services you're supposed to bill in lieu of the inactive codes. Below are partial excerpts of crosswalks used in the presentation, but please note that this information is not intended to be coding advice for physicians.
|
Consult
|
Key Elements (3/3)
|
X-Walk New/Established
|
Key Elements (mix)
|
|
99244
|
C/C/M
60 min
|
99204
99214
99215
|
C/C/M 45 mins
D/D/M 25 mins
C/C/H 40 mins
|
|
99243
|
D/D/L
40 min
|
99203
99213
99214
|
D/D/L 30 mins
EP/EP/L 15 mins
D/D/M 25 mins
|
|
Consult
|
KeyElements (3/3)
|
X-Walk
|
KeyElements (mix)
|
|
99255
|
C/C/H
110 min
|
99223
+99356
|
C/C/H 70mins
30 mins
|
|
99252
|
EP/EP/SF
40 min
|
99232
|
EP/EP/M 25 mins
|
Editor's note: Take a look at our Consultation Code Crosswalk Quick Card. This crosswalk will provide you with the information you need to ensure proper reimbursement for consult services rendered in 2010. For more information on this product, go to: www.decisionhealth.com/consultationcodecrosswalk.