DecisionHealth, DecisionHealth - 2011 Issue 9 (September)

E/M utilization soared and denials fell after consult elimination

The number of new patient E/M visits and initial hospital care codes skyrocketed from 2009 to 2010, driven by CMS’s decision to eliminate consult codes effective Jan. 1, 2010. All consult codes (99241-99255) were non-billable in 2010 and providers billed 99201-99205 and 99221-99223 instead. This shift in billing had no effect on denial rates, which fell for all the codes that replaced consults, a Part B News analysis shows.

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