Medicare Consults

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Medicare Consults

Postby jacqueline.simmons » Fri Oct 20, 2017 10:48 am

Palmetto in NC and SC has stated that Medicare Consults cannot be shared services. The deletion of the Consultation Codes did not negate the original intention of what a consultation is and therefore inpatient consultations (99221 - 99223) or office consultations (99201 - 99205, 99211 - 99215) cannot be shared by an MD/DO and a NPP. My question is can a consult for a Medicare patient be documented by a resident and the teaching physician provide the appropriate attestation statement and be billed under the teaching physician NPI with the GC modifier?
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Re: Medicare Consults

Postby admin » Wed Nov 01, 2017 1:56 pm

Teaching situations (residents/preceptors) is not the same as a split/shared visit. As long as the attestation from the preceptor is supported then it is allowed to be billed under the preceptors name. There are exceptions for primary care exception clinics, I have attached a copy of the guidelines below.

https://www.cms.gov/Outreach-and-Educat ... 006437.pdf

Your question has been answered by Omega Renne CPC, CPCO, CPMA, CEMC, CIMC
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