What’s New in Consultation Code Coverage – Ophthalmology Management

Medicare continues to change reimbursement rules, presenting challenges to ophthalmic practices. In 2010, coverage for consultation codes has been eliminated. Here’s a sample of some of the many need-to-know questions we are receiving.

This article answers the following questions:

• What changes were made to the payment policy for consultations?
• How will this change affect Medicare payments?
• What CPT codes replace the consultation codes?
• Is there a code “crosswalk” from outpatient consultation codes to E/M codes?
• Is there a code “crosswalk” from the inpatient consultation codes to the E/M codes?
• Is a written report back to the referring provider still required?
• Will commercial payers and Medicare Advantage (MA) plans continue to recognize consultation codes?
• Will commercial payers and MA plans continue to recognize consultation codes? What about Medicare secondary payer (MSP) claims?

This article was published in Ophthalmology Management’s Coding & Reimbursement column, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Ophthalmology Management, click on the link below:

http://www.ophthalmologymanagement.com/article.aspx?article=103927