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consult cpt codes ????

Nikhil Answered Tue 12th of April, 2011 14:16:35 PM

we recd' notice prev that cpt codes for consult ' -specialist billing these ranges 99244 99243 99241 99240 99245, to a specialist had been deleted obsolete now. no longer billable,2011 , can you confirm this....we were told to bill new pt, 95204 ranges , or 99215 -99217 follow ups...

also, can you tell me , we also process pathology, cytology...herre in office....when a specimen is collected, seperated into several specimens, one processed, one held for bacteria growth read 3 weeks later or so, but same sample date o of the 1 billed ,,what differentiates, this, for billing purposes,, we bill 1 on date spec'd held one billed 3 weeks later.....same cpt but biller later. i remmber a 25 -26 - and a 99 59 several mod for this billing purpose, , do you have a part modifier for the second 88235 held for bacteria growth 655.13 651.03 for both units billed....... can you clear this up....i remember billingt hsi type of service prev and a mod utilized for this... dont remember.... how would you bill 2 units 88235 , 1 billd ons mple date, one hled 3 weeks growth then bill 2nd units when ckd later........can you be of help in clearing this up??? thank you, i am virginia billing assitant pndx sacto ca 95815

Carol Answered Tue 12th of April, 2011 14:38:32 PM

The use of CPT consulation code ranges 99241-99245 and 99251-99255 were no longer recognized for Medicare Part B payments for services on or after January 1, 2010. I still use the consultation codes for commercial insurances. The 99217-99220 codes you mentioned are for outpt observation codes.
Hope this helps

SuperCoder Answered Tue 12th of April, 2011 16:25:42 PM

Consultation Code Range(99241--99245) for Outpatient services are neither deleted nor obsolete codes. It is Medicare only which is not going to pay for Consultation Codes. So, for Medicare, we should not bill Consultation Codes and code(bill) Office Visit Codes(99212-99215)instead.

But, for Non-Medicare the concept of Consultation Coding is same as it was earlier.

Coding Guidelines for CPT 88325 :-
These involve not only preparing and evaluating any slides and tissues that the outside institution sends, but also reviewing the full patient history such as surgical notes and oncology reports along with the tissues and slides.
> Unlike most other surgical pathology codes, the specimen is not the unit of service for 88321-88325.
> Report one unit of the appropriate code for one accession, which may include multiple specimens from one surgical pathology case or cytology case.[An accession includes tissue and/or slides from a single body site on a specific date].
> multiple slides or specimens from a single patient may comprise one or several accessions.
> For example: If your pathologist consults on referred slides taken from a lesion excision on one date and a margin re-excision taken a week later, list 88321 x 2

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