If Medicare denies a consultation service, what is the denial code? Should the physician bill the patient?
Claims for consultation services (99241-99245 and 99251-99255) provided after January 1, 2010 will be returned with a message indicating that Medicare uses another code for the service. The physician must resubmit the claim with the appropriate E/M code for the service and may not bill the patient for a non-covered service.
Related Questions
- If the patient is readmitted and the same physician is requested again for consultation, can we bill another initial inpatient hospital service code?
- How will Medicare pay for a consultation service requested by another physician in the same group practice?
- May a physician assistant (PA) see a new Medicare patient and bill the service "incident to?
