[epicproviders] Effective 1/1/2023: Providers- New Process for Reporting Inpatient Consult Services

[Epic - All Provider Staff]

Beginning January 1st 2023:   Please report inpatient consult services with either an "initial hospital inpatient or observation care" code (99221-23) or a "subsequent hospital inpatient or observation care" code (99231-33) instead of the inpatient consult codes 99252-55.
When CMS discontinued reimbursement for consult services in 2010, a backend code mapping was put in place to allow appropriate codes to be submitted to payors who do not reimburse consults.  Given 2023 CPT description changes, the inpatient consult mappings will no longer work and may result in lost reimbursement to providers.

Inpatient consult codes 99252-55 will be removed from inpatient charge capture in EPIC effective 1/1/2023.  Please note if you have these codes included in your favorites or an individual preference list you will need to manually delete them.

After 1/1/23 please select either an "initial hospital inpatient or observation care" code (99221-23) for your first encounter during that admission, or a "subsequent hospital inpatient or observation care code "(99231-33) for any services provided after the initial consult.

Reminder: You may only bill one consult  (codes 99221-23) per SUBSPECIALTY, PER ADMISSION. Once your subspecialty provides the initial consult, you use subsequent codes 99231-33) for your follow up services.


[IMAGE]

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://lists.upstate.edu/pipermail/epicproviders/attachments/20221229/5c4603c5/attachment-0001.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.png
Type: image/png
Size: 52671 bytes
Desc: image001.png
URL: <http://lists.upstate.edu/pipermail/epicproviders/attachments/20221229/5c4603c5/attachment-0001.png>