Consultation Codes – No longer accepted after July 1 2019.
Peregrine Healthcare received this notice from BCBS of Arizona. Wanted to make sure our Arizona clients got this as well. July 1 is around the corner.
As of July 1, 2019, consultation codes will no longer be accepted
Effective for claims received on or after July 1, 2019, consultation codes 99241–99245 and 99251–99255 will no longer be eligible for reimbursement. Blue Cross Blue Shield of Arizona is following the standard set by CMS in not recognizing these CPT® codes.
Please bill all professional consultation services with the appropriate evaluation and management (E/M) code from the 99201–99215 range. Select the E/M code that best describes the place of service and consultation complexity, and indicates whether the patient is new or already established with the provider .
Starting July 1, we will return claims with consultation codes 99241–99245 and 99251–99255 for the correct E/M code.
For additional information, see our new Consultation Services Pricing Guideline in the secure provider portal at “ azblue.com/providers > Provider Resources > Guidelines > Claim Pricing > Consultation Services Pricing Guideline.”
If you have questions, please contact your network contract specialist (NCS) or call the claims customer service number on the back of the member ID card.