How will billing for the consultation codes crosswalk to the office visit and initial hospital care codes?
While the key components of history, examination, and medical decision making for some consultation codes perfectly crosswalk to certain office and initial hospital care E/M codes, CMS states that the mappings are provided for the purpose of establishing budget neutrality of the work relative value units (RVU) and are not intended as billing guidance. In place of the consultation codes, CMS increased the RVUs for new/established office visits and initial hospital/nursing facility visits, and incorporated the increased use of these codes into the practice expense (PE) and malpractice calculations. CMS also increased the incremental work RVUs for the E/M codes that are built into the 10-day and 90-day global surgical codes. Physicians must bill the appropriate E/M code based on the level of service provided.
Related Questions
- Can a nurse practitioner or physician assistant do any part of a new patient office visit or consultation and still bill under the physicians billing number?
- Is there a direct crosswalk from consults to office/outpatient visits or consults to hospital or facility visits?
- Is the initial visit to Plastic & Hand a consultation only, or does it include a procedure?
