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Consulation Codes and Medicare
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An abstratct  on an article entitlted Is It Time to Eliminate Consultation Codes? An Analysis of Impact and Rationale by Joel I. Shalowitz, MD, MBA and reported in the Archives of Internal Medicine studies "issues of health care cost escalation and parity of payment between primary care and other physicians have become more important, one proposal has been to eliminate consultation codes. Little is known about the current payment accuracy or financial impact of such a change."

This study investigated "the impact of consultation code elimination....the results  of the 500 claims reviewed...Overall, the coding error rate was 32.4%. When the requesting physician ordered a consultation, the error rate was 5.5%; however, with lower paid referral requests, the error rate was 78.0%. Changing ambulatory consultation codes to those for new patient visits would save Medicare $534.5 million per year."

The authors of this study conclude that "consultation codes are being billed erroneously at a high rate. Furthermore, the differential cost to Medicare of these codes over those for new patient evaluation and management codes is over half a billion dollars per year. With the growing needs for cost savings as well as encouraging payment parity for cognitive services for primary care physicians, it is time these codes are reevaluated."

Just a reminder to those who aren't aware:  Doctors of Chiropractic are NOT included in this figure for this is a "non-covered Medicare service" for chiropractic.  ONLY the medical community is responsible for this "erroneously high" billing resulting in 1/2 BILLION dollars extra to the Medicare system.

Perhaps Medicare should PROMOTE CHIROPRACTIC as a cost savings device.
 
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Most Recent Comments
Added: January 29, 2010. 08:35 AM CDT
YES!!!
Imagine, a HEALTH care system actually promoting the restoration and preservation of health, rather than promoting "the dramatic symptomatic relief of dysfunctioning systems."

Every tool has its place, but we DO need as much emphasis on SUSTAINING health as we do on "recipes" that provide the illusion of health restoration.
Anonymous
 
 
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