CPT 2010: Here's the Lowdown on 2010 Consultation Changes

Why This Topic Matters

The article is relevant because payer policy changes can affect which E/M services are reportable and how those services are reimbursed in 2010. It helps coding professionals understand where consultation reporting may still be recognized and where other E/M categories are being used instead.

Article Sections

1. Codes Remain — But When Can You Use Them?

   Introduces the 2010 consultation-code policy shift and discusses the difference between Medicare treatment of consultation services and the CPT manual’s continued inclusion of the codes. Also notes the effect on reimbursement and payer adoption trends.

2. Watch other payers

   Describes how commercial payer policies may differ and why coding staff need to confirm each payer’s approach. Includes broad discussion of uniformity efforts and the need to map consultation services to other E/M categories when required.

3. Apply Patient Status Rules to Outpatient Encounters

   Covers the general move from consultation reporting to standard E/M coding for outpatient encounters and how patient status concepts become important. Includes an example involving an office encounter and documentation considerations.

4. Look at Time When Choosing Inpatient Code

   Discusses hospital-based coding issues when consultation services are evaluated against other inpatient E/M categories. Highlights the different reimbursement impact across service levels and the need to match services carefully.

5. Don't miss mismatch

   Addresses differences between consultation and hospital care coding at lower service levels and the potential for non-equivalent crosswalks. Notes that additional guidance may be needed where service requirements do not align cleanly.

6. Consider using time to line up the services

   Mentions the use of crosswalk concepts as a general guide and cautions against treating them as official coding instructions. Focuses on aligning services conceptually rather than reproducing exact payer logic.