Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
Chest. 2011 Apr;139(4):933-938. doi: 10.1378/chest.10-1340.
A consultation service provides expert opinion or advice at the request of another provider. The Centers for Medicare and Medicaid Services (CMS) eliminated reimbursement for the outpatient and inpatient consultation codes traditionally used to report these services (CPT 99241-99245 and 99251-99255, respectively), and private payers are likely to follow suit. CMS has instead mandated that these services are mapped to new or established visit codes for outpatients (99201-99205 or 99212-99215) and to initial or subsequent hospital services codes for inpatients (99221-99223 or 99231-99233). This article reviews appropriate medical consultation and provides specific guidance for the reporting of these services to CMS and other payers not reimbursing consultation codes.
咨询服务应其他提供者的请求提供专家意见或建议。医疗保险和医疗补助服务中心（CMS）取消了传统上用于报告这些服务的门诊和住院咨询代码（分别为 CPT 99241-99245 和 99251-99255）的报销，私人支付者可能也会效仿。CMS 已要求将这些服务映射到新的或现有的门诊就诊代码（99201-99205 或 99212-99215）以及住院患者的初始或后续住院服务代码（99221-99223 或 99231-99233）。本文回顾了适当的医疗咨询，并为向 CMS 和其他不报销咨询代码的支付者报告这些服务提供了具体指导。
