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Vital Info on Consults: How the CMS and CPT Changes will Impact Your Practice

Vital Info on Consults: How the CMS and CPT Changes will Impact Your Practice

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by Betsy Nicoletti, MS, CPC

You've heard the news: CMS did eliminate payment for consults beginning January 1, 2010 in their Final Rule. Your practice has only weeks to develop your coding procedures for reporting these services and educate physicians, Non-Physician Practitioners, coders and billers. Register today to hear a fast-paced audio conference discussing how the AMA has changed their editorial content regarding consults. How is it working? What are other payers doing? How can you implement these new rules successfully?
Review of the CMS rules
  • How to bill for " "consult" " services in the Office, Emergency Department, Inpatient Unit and Observation
  • Correct use of Modifiers
  • The Implications of Specialty Designation
  • Hospitalist services
  • Coverage
  • CPT editorial changes
  • Transfer of Care
  • Determination Whether to Accept Care of the Patient
  • Private Payers: Do We Need to Worry?
  • Crosswalks: To Use or Not to Use
  • Documentation Guidelines for Each Level of Service
  • Physician Involvement in Code Selection
  • Claims Editing
  • Medicare as a Secondary Payer
  • Medicare Rules
  • Practical Considerations and Electronic Processing
  • Other payers
  • Medicaid, Medicare Advantage
  • Private payers
  • This audio conference will clarify how the rule change will change how to bill for hospital services, Non-Physician Practitioners and specialists. Practices need to understand the hard choices for billing Medicare patients with secondary insurance policies that may or may not follow Medicare rules, and what to do when Medicare is the Secondary Payer.

    Meet Our Expert Speaker:

    Betsy Nicoletti is the co-founder of, a website which is dedicated to providing user-generated, free reimbursement information for physician practices. She is also the author of the Physician Auditing Workbook, published by DecisionHealth and The Field Guide to Physician Coding published by Greenbranch Publishing.

    Betsy speaks nationally on coding education.

    In addition to writing and speaking, Betsy educates physicians and coders and helps practices with complying with government regulations while collecting all of the reimbursement they are entitled to collect. Her consulting firm is Medical Practice Consulting.