With all the current discussions on medical records and coding, the American Medical Association today has a with a study to shed some light with a surprise change in billing with the removal of consultation fees.  Sometimes it may be hard to predict exactly how the math will work.

Consultation fees with Medicare billing were eliminated for the most part beginning in 2010.  Contrasting this number, office visits increased by over six percent.  Consultations were paid at a higher rate than just a standard office visit.  To adjust for the elimination of the billing code, other code reimbursements were increased.  The total number of visits did not change substantially but higher level services were billed after the consultation codes were gone.  The AMA states that they believe the codes should be restored.  This change was supposed to be neutral and not have any effect but the numbers tell us something else.  Medical record coding connections were also changed to reflect the elimination of the codes to no longer be available.

In short, what was accomplished is the question that might be asked?  The chart below from the study shows the numbers and the consultations shown in 2010 were for claims prior to the cut off of using the consultation codes.  Based on the data and information contained here, this uptick was not the fault of electronic medical records but rather relates to policy changes instead.


“Washington Eliminating the popular consultation billing option for physicians was intended to have a negligible effect on Medicare spending, but the policy change had unintended consequences that led to an increase in net Medicare spending, suggests a study from Archives of Internal Medicine.

Higher fees authorized by Medicare for outpatient office visits and a sizable increase in physicians billing more complex evaluation and management codes were reasons cited for the higher spending. The elimination of consults led to a 6.5% increase in spending on office visits in 2010, the study said.”