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Dec
6
Written by:
Amanda Patanow
12/6/2009
In the calendar year 2010 Physician Fee Schedule (PFS) proposed rule 74 FR 33551, the Centers for Medicare & Medicaid Services (CMS) has proposed and accepted comments on the following changes regarding billing CMS either as a primary or secondary insurance carrier for consultation codes.
Beginning January 1, 2010, CMS will eliminate all consultation codes (except those used for telehealth). They will be replaced using the following mapping guidelines.
| Office Consultation |
To Office Visit |
| 99241 |
99201 |
| |
99211 |
| 99242 |
99202 |
| |
99212 |
| 99243 |
99203 |
| |
99213 |
| 99244 |
99204 |
| |
99214 |
| 99245 |
99205 |
| |
99215 |
| Consultation Initial Inhouse |
To Hospital Initial Visit (*=NH) |
| 99251 |
99221 |
| |
99304* |
| 99252 |
99221 |
| |
99222 |
| |
99304* |
| |
99305 |
| 99253 |
99222 |
| |
99305* |
| 99254 |
99222 |
| |
99223 |
| |
99305* |
| |
99306* |
| 99255 |
99223
99305*
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To obtain a neutral budget, the office E/M codes (99201-99215) will be increased by 6% and the hospital E/M codes (99221-99223) will be increased by 3% to make up for the decreased revenue from the loss of the consultation codes.
It is now more important than ever to code appropriately for your work RVUs. Aprima PRM’s coding guidelines are excellent suggestions when you need assistance in coding your visits. Nobody wants to code inappropriately on either side of the equation — lower or higher. We at Aprima want our clients to code appropriately at all times.
In these challenging times of practicing medicine, one of Aprima’s main goals is to assist our clients in capturing additional revenue. The new e-Rx requirements for 2010 state that only 25 electronic prescriptions need to be generated to receive the full 2% from CMS. The 50% requirement has been eliminated. This along with the 2% incentive for successfully completing the PQRI rules are two great ways to help the financial well being of your practice. Aprima is extremely proud of our PQRI section, especially its ease of operation and fluidity within FNC.
So in summary, get your full 4% additional incentive from CMS with e-Rx and PQRI in 2010, and code appropriately to make up for the phasing out of the consultation fees.
Sincerely,
Jeffrey Hyman, M.D.
Chief Medical Officer
Aprima Medical Software, Inc.
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