ASCRS Coding Corner
2010 CPT Changes
1. Elimination of Consultation Codes for Medicare Reporting
Effective January 1, 2010, the CPT consultation codes (ranges 99241-99245 and 99251-99255) will no longer be recognized for Medicare Part B payment. For services furnished on or after January 1 2010, providers will need to report a patient evaluation and management visit with E/M codes that represent where the visit occurs (hospital or office/outpatient) and that identify the complexity of the visit performed. The guidelines that CMS has established for reporting are extensive. The following link provides the CMS Consult Code Directives. Please take the time to read this information thoroughly so that your reporting for consultation services will be correct. Also keep in mind that other Third Party payors may not have signed on to this change. The consultation codes and their RVUs will still be published in the Physician Fee Schedule - just not recognized by CMS. Therefore, unless specifically directed, you may need to continue using the consultation codes for non-Medicare payors.
Stay tuned…. the AMA, along with most surgical and medical societies, have urged CMS to delay implementation of these changes. To date, CMS has not responded against or in favor of a delay. Prior to January 1st, a decision could be made or CMS could make a decision after January 1st and make it retroactive. ASCRS will keep you informed as this drama plays out, but it will be essential that you follow your claims payments from CMS and all payors closely for the first few months of 2010.
2. Revisions to Colon and Rectal Surgery Codes
A large number of changes have been made to codes that are important to colon and rectal surgeons. The changes address issues such as deletion of services that are rarely performed and relocation of codes to other codes that are more closely related. These changes are effective January 1, 2010. Also note that CPT has decided to assign code numbers that are "out of sequence." Please make your coding staff aware of the code numbers that are key to your practice. The following link presents coding changes important to colon and rectal surgeons, as printed in CPT 2010: Coding Changes for CRS.