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Medicare Changes to 2010 CPT Inpatient Consultation Codes

Posted on 13. Nov, 2009 by in Provider News

Prevent 99251-99245 denials in 2010 with this checklist.

Multiple physicians using the same hospital codes sounds like a recipe for denials, but that’s what Medicare is instructing physician inpatient consultants and care coordinators to do.

Whether carriers will kick out these submissions as coordination of care or inpatient admit limiting admit edits is contractor specific, Charles E. Haley, MD, MS, FACP, Medicare medical director for Trailblazer Health Enterprises, LLC, told the audience during the E/M session at the 2010 CPT symposium. “If come January you’re getting denials, work out the issues with your specific contractor.”

You can, however, prevent many rejections from Medicare’s invalidation of 99251-99245 by following this checklist.

√ Use Initial Hospital Day Codes on Day 1

If a physician consults a patient on his first day in the hospital, you should use an initial hospital code (99221-99223), according to Medicare’s new consultation guidelines for 2010. “Stop thinking of...

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