Forum - Questions & Answers

Feb 5th, 2010 - tracyc271 30 

Billing MSP

Hello everyone- can you all help me to find the easiest way to bill to MSP when I have a consult or and admit to the hospital? Are you all billing prim insurance the consult code then changing things to the new patient code before sending to MSP? What about the AI mod for being the admitting doc? Are you just sending the admit level to the prim insurance and then stopping the MSP claim to add the AI modifier?

Why does this have to so hard!!

Feb 6th, 2010 -

Yes

You describe it perfectly; I have no idea what a commercial insurer would do with an -AI but why take the chance? Remember that Medicare will process claims without the -AI since they really can't know who is the primary doc, and that there is no direct crossover from consult codes (5 choices) to Initial codes (3 choices) so you have to either guess or go thru the note and see what the documentation justifies when you make the switch.

Feb 8th, 2010 - tracyc271 30 

Msp

I have to say that this is one thing that has caused ALOT of headaches, doubt, confusion and complete FRUSTRATION!!!! Thanks for you help

Feb 8th, 2010 - Codapedia Editor 1,399 

MSP and consults

There is an article on the Codapedia site about this and all I can see: it isn't pretty. There are no really good choices.



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