Compliance Focus Coding Changes for 2006
Current Procedural Terminology (CPT), the AMA publication that is the national coding standard for reporting professional services and procedures for billing and reimbursement, has made important changes to some codes in the “Consultation” category of the Evaluation and Management Code section. Effective this month, the Confirmatory (Second Opinion) Consult codes (99271-99275) and the Follow-up Inpatient Consult codes (99261-99263) have been eliminated.
CPT instructs users to report Confirmatory Consults that are patient or family initiated using the Office/Outpatient Visit codes 99201-99205 (new patient) or 99211-99215 (established patient). Confirmatory Consults requested by another physician or appropriate source should be coded using the Office/Outpatient Consult Codes (99241-99245) and must meet existing standard documentation criteria for Consultations (Documented Request, Rendering of an Opinion and written Report back to the requesting physician).
Follow-Up Inpatient Consults should be reported using the Subsequent Hospital Care codes 99231-99233.
Contact Rhonda Flanagan with questions at ext. 2-9382 or e-mail rflanagan@partners.org