But BCBS does honor this code and so do many other insurance companies. Answer: You are correct; the inpatient and outpatient consultation services (i.e. UnitedHealthcare announced earlier this year that they would eliminate the consultation codes in two phases. job and medical necessity requirements to report a code for subsequent hospital care (below the level selected), even if the code reported is for the providers first e/m service to the inpatient during the hospital stay. In the inpatient hospital and nursing facility setting, physicians (and qualified non-physician practitioners where permitted) may bill the most appropriate initial hospital care code (99221-99223), the subsequent hospital care code (99231 and 99232), the initial hospital care code, facility care code (99304-99306), or subsequent nursing facility care code (99307-99310) reflecting the services provided by the physician or practitioner. Consultation Codes Update, October 2022: The CPT books have arrived! what should a consulting physician bill when treating a medicare hospital patient? Don't forget since consults still use the 95/97 guidelines, you may frequently get a higher level with 99202-99215 if your clinician misses an exam bullet point or doesn't completely document a history. There is a reason chiropractors have trusted H.J. Keep your Aetna provider ID number (PIN) handy to access them. These two low level consult codes were rarely used. Requests, rendering and replies . This policy aligns with CMS guidance and does not allow reimbursement for inpatient (99251-99255) or outpatient (99241-99245 . In this article about consultation codes update: See E/M changes for 2021 for additional E/M related resources. We will no longer pay office consultation codes Nonparticipating-provider standard timely filing limit change We've changed the standard nonparticipating-provider timely filing limit from 27 months to 12 months for traditional medical claims. Effective Date: January 4, 2021 End Date: Issue Date: January 1, 2023 Revised Date: January 2023 Date Reviewed: December 2022 Source: Reimbursement Policy PURPOSE: . Most groups suggest that their clinicians continue to select and document consults (when the service is a consult) whether or not they know if the payer recognizes consults or not. She knows what questions need answers and developed this resource to answer those questions. what insurance companies accept consult codes 2021. Billing Consultation Codes When Medicare is Secondary. It is necessary to realize, that each insurance company may have different and predetermined policies delineating which codes are approved for payment to various provider types. Some examples of CPT codes are: 99201 through 99205: Office or other outpatient visit for the evaluation and management of a new patient, with the CPT code differing depending on how long the provider spends with the patient. 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The correct start date is March 1, 2022. The provider will need to resubmit the claim with the appropriate new or established evaluation and management codes (99201-99205; 99211-99215; 99281-99285; 99221-99226, 99304-99310) as described in this Policy.