ASTROgram: CMS releases educational article on new consultation policy

CMS eliminated payment on consultation services for fee-for-service Medicare beginning January 1, 2010. Providers are being advised to report E/M visit codes for consultation services. To assist providers with the implementation of this new policy, CMS has released an article on this topic. As reported earlier, ASTRO received specific guidance from CMS on this new policy as it related to radiation oncology procedures.  Effective January 1, 2010, CMS modified the edits bundling CPT codes 99201-99215 and 99221-99223 into radiation oncology procedures to allow for the use of NCCI-associated modifiers. As a result of ASTRO’s request and NCCI's reconsideration, these codes may be reported only once with an NCCI-associated modifier for the initial consultation with the patient. With a single exception these E/M codes should not be reported with an NCCI-associated modifier for other E/M services during the course of radiation therapy and 90 days after the last treatment. The sole exception is CPT codes 77785-777876, which allow separate reporting of E/M services.