BC Advantage - 2011 Issue 12

CMS issues clarification of E&M policy

Since January 1, 2010-when CMS decided to no longer recognize the CPT consult codes for payment (99241-99255)-some E/M coding issues arose that made things a bit more fuzzy. One issue, for example, is the fact that prior to the change, it used to be understood that the initial hospital care codes (99221-99223) were to be used by the admitting physician. To this day, CPT still states that the initial hospital care codes are used to report the first hospital inpatient encounter with the patient by the admitting physician. CMS no longer follows this CPT coding rule since it states...

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