Consultation coding error rates show need for more improvement

Why This Topic Matters

Consultation claims have been a significant source of Medicare payment error, so understanding the compliance concerns can help practices reduce denials, down-coding, and documentation-related risk.

Article Sections

1. Error-rate review and Medicare focus

   Summarizes the Medicare and audit findings that prompted renewed attention to consultation services and the types of problems being reviewed.

2. From four consult types to two

   Describes the broad consult categories discussed in the article and the setting-based framework used to distinguish them.

3. 10 consult pointers to keep in mind

   Reviews general consultation concepts, documentation expectations, reporting relationships, and operational considerations for consult services.

4. Improve consult documentation

   Focuses on documentation practices for consultation requests and written records, including references to Medicare documentation expectations.