Outpatient Facility Coding Alert - 2010 Issue 14
SPLIT/SHARED VISITS: CMS Clarifies Split/Shared Visit Rule Now That Consults Are No Longer Payable
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Article Overview
This article explains CMS comments intended to reduce confusion about Medicare billing after consultation services were no longer payable. It focuses on split/shared visit reporting under E/M rules, inpatient hospital care billing questions, and the use of current versus older bone density testing codes. The content is most relevant to coders, billing staff, and clinicians working with Medicare compliance and hospital E/M reporting.
Why This Topic Matters
The article highlights Medicare billing clarifications that can affect how practices report E/M services, inpatient hospital encounters, and bone density testing. It is important for avoiding payment errors and aligning reporting with current CMS guidance.
Article Sections
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Split/Shared Visits and E/M Billing After Consult Payment Changes
Discusses CMS comments on split/shared visit reporting in the context of Medicare consultation payment changes. The section centers on general E/M billing guidance and the clarification effort surrounding prior confusion.
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CMS Advises Practices to Rein in Initial Inpatient Billing
Addresses a billing question about initial and subsequent hospital care reporting for a patient seen more than once on the same date. The section also references CMS commentary on per diem inpatient services and related published rules.
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Use Current Bone Density Codes
Covers a question about bone density test reporting in light of newer coding guidance versus older listed codes. The section focuses on which code set version practices should continue using.
What You Will Learn
- How CMS described split/shared visit billing in relation to Medicare E/M reporting
- What general inpatient hospital care billing issue was raised during the CMS discussion
- How the article frames the use of current bone density testing code ranges versus older references
- Which CMS communications were mentioned as part of the clarification context
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Physicians
- Hospital revenue cycle staff
Codes Discussed
Code Ranges Discussed
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