endobj These two low level consult codes were rarely used. Effective Date October 19, 2019 for claims processed on or after this date. Humana Medicare Advantage and commercial plans align with Original Medicare for the reporting of these prolonged services. Generally, BCBSMS follows CPT, HCPCS and ICD-10-CM national coding guidelines. In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. Modifier -32 CPT modifier -32 is intended to identify cases in which a consultation was mandated by entities such as a third-party payer, government agency, or regulatory requirement. B{rZyNR EA kH:VuI`uy3ITs2R]2rlS!>Q`ZZpW#=Q;^hRLf$Az\* 257 0 obj The question is, how should they be billed? 227 0 obj For the IP scenario only you would add modifier AI if your provider was the admitting and/or attending physician who oversees the patient's care, as distinct from other physicians who may be furnishing specialty care. 0000010821 00000 n Hello I was wondering by chance do either one of you have a list of carriers that are not excepting the consult codes other than Medicare and Medicaid? There is no longer a notation that says you cannot bill a consult for a transfer of care. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. Carol-Where did you here that CMS may be reconsidering? The provider will be paid according to the fee schedule for the equivalent procedure code. %%EOF What should a consulting physician bill when seeing a hospitalized Medicare patient? <> C CatchTheWind Guest 2. 0000003850 00000 n At first, most continued accepting the codes. <> 0000028304 00000 n 0000026814 00000 n 0000004290 00000 n Oh wellI guess all these changes are good for our brains! endstream For office and outpatient services, use new and established patient visit codes (9920299215), depending on whether the patient is new or established to the physician, following the CPT rule for new and established patient visits. You likely will not get paid for a consult requested by one of these professionals. Chances are your dealing with Dr. A wants the patient to be evaluated by Dr. B, and Dr. B wants to bill a consultation which is incorrect. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. endobj 0000001743 00000 n 0000013094 00000 n Privacy Policy. From 2023 CPT: A consultation is a type of evaluation and management service provided at the request of another physician, other qualified health care professional, or appropriate source to recommend care for a specific condition or problem. 0000064141 00000 n Where do I go for the definitive answer ? All rights reserved. 0000028543 00000 n Here's how to crosswalk the consult codes to E/M codes based on MDM or time: E/M based on MDM My question to you is are you meeting all three requirements of a consultation? CPT has removed the coding tip and all language regarding transfer of care. Therefore, Humana plans only allow HCPCS codes G2212, G0316, G0317 and G0318; and Humana plans do not allow 99417 or 99418. 0000006009 00000 n 0000003954 00000 n In 2023, codes 99241 and 99251 are deleted. An initial hospital service or a subsequent hospital visit? 219 0 obj 222 0 obj When CMS stopped paying for consults, it said it still recognized the concept of consults, but paid for them using different categories of codes. Furthermore, the differential cost to Medicare of these codes over those for new patient evaluation and management codes is over half a billion dollars per year., consult codes have changed to other E&M codes. Category of code for payers that dont recognize consult codes, Definition of a consultationupdated with 2023 CPT guidance, There is a request from another healthcare professional or other appropriate source. I am looking for information that the insurance companies have put on there web sites. <> 0000003617 00000 n Cigna will become the second payer to discontinue payment for consultation services in 2019. The citation from the Medicare Claims Processing Manual is at the end of this Q&A. 0000007877 00000 n 0000004462 00000 n <> These codes are used for the inpatient History and Physical (H & P), as well as any specialty consultation (limited to one visit from each specialty). <>stream Jan. 1 has come and gone and so, too, have CPT consultation codes (99241-99255). Effective for claims with dates of service on or after Oct. 1, 2019, UnitedHealthcare aligns with CMS and does not reimburse consultation service codes 99242-99245, 99252-99255, including when reported with telehealth modifiers for any practice or care provider, regardless of the fee schedule or payment methodology applied. We are looking for thought leaders to contribute content to AAPCs Knowledge Center. Coding and Modifier Information Q` 0WLedE,Zs]q2hG1~. me/_ onuxT|W8v1Y,r[qoL9NWpSS'9+y^h\nD*c4[=q.q4w:@]$Lu(Bg`E9z7^S$i+d*,Si7``*MIUoUky4>NDm,j>Pab;X,#bFrx>rUI W-S+|:drFOqyk ~3sHm9p3iX~.JZ,B;t,IdDMRw"JA?6X6ifg|. Consult Codes The list we have is BCBS, Aetna, Work Comp, and Auto only. 0000005777 00000 n I just heard yesterday that CMS may be reconsidering on the Consult codes. 224 0 obj For patients seen in the emergency department and sent home, use ED codes (9928199285). The CMS Claims Processing Manual, Chapter 12, 30.6.9 F. Physicians may bill initial hospital care service codes (99221-99223), for services that were reported with CPT consultation codes (99241 99255) prior to January 1, 2010, when the furnished service and documentation meet the minimum key component work and/or medical necessity requirements. 0000001594 00000 n It makes for bigger bureaucracy and more Indian Chiefs! #3. It can affect the timeliness and accuracy of claim payments. To bill for HCPCS codes G2212, G0316, G0317 and G0318, providers must meet all applicable . Watch out with BCBS especially because if you code an initial hospital visit when it was actually a consult (as is the common practice with any other payer), they will recoup their payment and you'll have to resubmit a corrected claim. endobj Assuming you meet the coding definition of consult, if 98% of your consult codes get denied, that does not seem like a great way to get paid. UnitedHealthcare announced earlier this year that they would eliminate the consultation codes in two phases. In the inpatient hospital setting and the nursing facility setting, physicians (and qualified nonphysician practitioners where permitted) may bill the most appropriate initial hospital care code (99221-99223), subsequent hospital care code (99231 and 99232), initial nursing facility care code (99304-99306), or subsequent nursing facility care code (99307-99310) that reflects the services the physician or practitioner furnished. Check Payer Policies for Consult Code Coverage, Tech & Innovation in Healthcare eNewsletter, Ask 3 Questions to Head Off 2010 Consult Problems. 0000001786 00000 n However, they should be reported if a decision to accept transfer of care can't be made . An example of upcoding is an instance when you provide a follow-up office visit or follow-up inpatient consultation but bill using a higher level E&M code as if you had provided a comprehensive new patient office visit or an initial inpatient consultation. Incidental Procedure Codes (PDF, 73 KB) MDwise N/A N/A Not covered for dates of service (DOS) on or after February 1, 2015 Follows Medicare Policy Not Covered MHS N/A N/A Not covered for dates of service (DOS) on or after February 1, 2015 Follows Medicare Policy Not Covered Medicare Effective January 1, 2010, does not covers consultation codes Follows Medicare Policy Not Covered N/A . professional who has agreed to accept transfer of care before an initial evaluation. 233 0 obj After CMS eliminated the codes Jan. 1, private payers could choose to continue reimbursing the codes or follow CMS's lead. When reporting a consultation code follow CPT rules. endobj Report new outpatient E/M code if patient has not been seen by you or another MFM in your group in the last 3 years Report established outpatient E/M code if patient has been seen in the last 3 They wont know. 223 0 obj AiE1qi V $`p_p4O- Refer to the following documents for Blue Shield's payment processing logic and procedure codes: Blue Shield Payment Processing Logic (PDF, 18 KB) Hospital Acquired Condition (HAC)/Never Events Codes (Excel, 346 KB) Effective 10/01/2022 - 09/30/2023. Because the depression screening does not require an interpretation and report, it is not separately paid by this payer. While we think of them and even talk about them as admission codes, CPT doesnt use that word. <> In recent years, private payors have followed suit: Health Net no longer reimburses consultation services and UnitedHealthcare has announced its intention to stop recognizing the consult codes, as well. <> According to the author, Joel I. Shalowitz, MD, MBA, Consultation codes are being billed erroneously at a high rate. Fasten your seatbelts. A physician or other qualified health care professional consultant may initiate diagnostic and/or therapeutic services at the same or subsequent visit.. endobj 0000002225 00000 n Consultation services are described with CPT codes 99242-99245 (office and outpatient) and 99252-99255 (inpatient and observation). Yes, I agree; making the rules clearer and getting rid of some of those acronyns would be a good start for sure. Is it Time to Eliminate Consultation Codes? We maintain and annually update a List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes (the Code List), which identifies all the items and services included within certain designated health services (DHS) categories or that may qualify for certain exceptions. Consultation Codes Update, October 2022: The CPT books have arrived! 235 0 obj trailer <> Use either medical decision making or the practitioners total time on the date of the visit to select the level of service. For more about Betsy visit www.betsynicoletti.com. endobj The AMA has extended the framework for office and outpatient services to consults in 2023. Last revised October 28, 2022 - Betsy Nicoletti Tags: office and other E/M. Neglecting to bill consults when the carrier pays them results in lost revenue. Watch How You Code for Facet Joint Injections. Print Post Jan. 1 has come and gone and so, too, have CPT consultation codes (99241-99255). More government bureaucracy yet to come! UnitedHealthcare, for example, recently communicated to members that it has implemented the CMS regulations for its UnitedHealthcare Medicare Solutions, including SecureHorizons, AARP MedicareComplete, Evercare, and AmeriChoice Medicare Advantage benefit plans, but says it will continue to reimburse commercial plans forCPT codes 99241-99245 and 99251-99255 at this time. startxref As predicted, Medicare Administrative Contractors (MACs) and other payers have implemented this policy change brought forth by the Centers for Medicare & Medicaid Services (CMS). Sacrifice: A payer that still accepts the consultation codes probably has not adjusted its fee schedule, like Medicare has, to allow higher payment for other E/M codes. Physicians may report a subsequent hospital care CPT code for services that were reported as CPT consultation codes (99241 99255) prior to January 1, 2010, where the medical record appropriately demonstrates that the work and medical necessity requirements are met for reporting a subsequent hospital care code (under the level selected), even though the reported code is for the providers first E/M service to the inpatient during the hospital stay. Do not use CPT consultation code ranges 99241-99245, 900-3925-0617 99251-99255 or HCPCS consultation codes G0406-G0408, G0508, G0509 or G0425 . P`LS=$6XSEzH.TD1 Copyright 2023, CodingIntel endobj These two low level consult codes were rarely used. If the documentation doesnt have a detailed history and detailed exam, then bill a subsequent hospital visit, rather than the initial hospital care services. They published this in July 2008 and all societies were aware of the change coming. To prepare your practice for issues that may ensue due to the most recentevaluation and management (E/M) coding changes, read Ask 3 Questions to Head Off 2010 Consult Problems.For current CMS instructions pertaining to consult codes, refer to MLN Matters revised article MM6740. On June 1, 2019, UHC discontinued payment for practices whose contracted rates are based on a stated year 2010 or later Medicare fee schedule. If you do not agree to the terms and conditions, you may not access or use . The appropriate follow up codes for the hospital setting are CPT codes 99231-99233, and the appropriate . 0 Hope this helps! Only the preventive medicine E/M service code, reported with ICD-10 codes . 0000003594 00000 n 0000028068 00000 n Services initiated by a patient and/or family and not requested by a physician or other appropriate source should not be reported using CPT consultation codes 99241-99245 or 99251-99255 or HCPCS consultation codes G0406-G0408 or G0425-G0427, but may be reported using appropriate office visit, hospital care, home service or domiciliary/rest home Its important to note, however, that this change in coverage applies to public health plan options only. Many commercial plans continue to reimburse for consultation services. Bill primary payer consult codes: Your second choice is to bill the primary payer using the consult codes. She has been a self-employed consultant since 1998. %PDF-1.7 % Coding Policy Internet Disclaimer A The code categories remaining to report consultations are code 99241-99245 for office or outpatient consults and 99251-99255 for inpatient consults. CPT 96040 Genetic Counseling (time-based, face-to-face time) is also in the CPT set of codes that can be . 0000005607 00000 n The following are the most common reasons HCFA/CMS-1500 and UB/CMS-1450 paper claims for Veteran care are rejected: Requires the 17 alpha-numeric internal control number (ICN) [format: 10 digits + "V" + 6 digits] or 9-digit social security number (SSN) with no special characters. 221 0 obj <>/Metadata 24 0 R/Pages 23 0 R/StructTreeRoot 26 0 R/Type/Catalog/ViewerPreferences 221 0 R>> HWMoF2r>\!(E:]3+)U"m@%y3e9mtRI{2E~ Wc2.WH,BAW f8 [ xc$. 0000064329 00000 n 226 0 obj For claims processed on or after Oct. 19, Cigna said in a recent payment update that it. There are four levels of office/outpatient consults and hospital consults. 75% of consult are inappropriate, I guess this was doctors own doing. AmeriChoice Medicaid plans that follow Medicare rules for their fee schedules have also implemented CMS rules. The consultants opinion and any other services that were ordered or performed must also be communicated by written report to the requesting physician, other qualified health care professional, or other appropriate source.. C c7hill Contributor Messages endobj Earn CEUs and the respect of your peers. In 2023, codes 99241 and 99251 are deleted. Some physician practices billing consultation codes (99241-99245, 99251-99255) to private payers running Medicare Advantage plans have recently reported receiving denials. <<878261B3EBB5B2110A00B0933B5DFE7F>]/Prev 149677/XRefStm 1415>> Subsequent hospital care codes could potentially meet the component work and medical necessity requirements to be reported for an E/M service that could be described by CPT consultation code 99251 or 99252. CPTcodes identify a particular procedure or service If a specific CPTdoes not exist that identifies the procedure or service, an unlisted code must be utilized Coding is the translation between the physicians written word and the dictionary used by payers to interpret them into numbers What Do the Codes Say? <>stream endobj If you provide consultations to Cigna members, be aware that Cigna will soon no longer pay those codes. When you look in your book, notice that CPT has entirely removed the concept of transfer of care. A/B MACs (B) shall not find fault in cases where the medical record appropriately demonstrates that the work and medical necessity requirements are met for reporting a subsequent hospital care code (under the level selected), even though the reported code is for the providers first E/M service to the inpatient during the hospital stay. ~]@Zu"@E0Ld\pQ,P,Nca|!a2E6YYVpg0A2cFa.dNdc(8L.@Y ,1 The affected CPT codes are 99241, 99242, 99243, 99244, 99245, 99251, 99252, 99253, 99254, and 99255. <> 0000014227 00000 n This is not a substitute for current CPT and ICD-9 manuals and payer . Another example of upcoding related to E&M codes is misuse of Modifier 25. The advantages to using the consult are codes are twofold: they are not defined as new or established, and may be used for patients the clinician has seen before, if the requirements for a consult are met.. endobj Some payers may not agree with the advice given. 0000003057 00000 n Outpatient consultations (9924199245) and inpatient consultations (9925199255) were still active CPT codes, and depending on where you are in the country, are recognized by a payer two, or many payers. Please recall that CMS/Medicare and several other payers still do not recognize or accept consultation codes, and we do not anticipate that this would change during a public health emergency. Starting March 1, 2022, we will no longer pay office consultation codes 99241, 99242, 99243, 99244 and 99245. Remember, Medicare does not accept consultation codes and nothing changes for Medicare in 2023; the consultation codes in the Medicare fee schedule continue to have an Invalid code status. endobj 0000063593 00000 n A consultation is provided by a physician or qualified healthcare professional at the request of another physician, qualified healthcare professional, or other professional source. please indicate your agreement by clicking below on the button labeled "I Accept". 0000005475 00000 n Invalid Service Facility Address. Here's our dilemma: We have a number of commercial payers who say they follow Medicare rules on split/shared visits, but they still recognize consult codes 99241-99245 (for office consults) and 9925199255 (initial inpatient consults). Medicare stopped recognizing and paying consult codes, but consults are still requested and provided to inpatients every day. They are used to help identify whether health care services are correctly coded for reimbursement. The requirements for a consultation have not changed. She knows what questions need answers and developed this resource to answer those questions. [250] In this article about consultation codes update: See E/M changes for 2021 for additional E/M related resources. CodingIntel was founded by consultant and coding expert Betsy Nicoletti. 229 0 obj 0000012036 00000 n endobj endobj This is challenging to answer as there is not an agreed upon interpretation of the rule. You would use 99221-99223 or 99218-99220 depending if the admission is IP or Observation respectively. In the past, the codes 99221-99223 were used only for the admitting physicians, and the codes 99251-99255 were . hb```b`` @QRy`2I&iLKHbD` juqh Helps ward off Alzheimers..right? xref The use of Coding Policy is not intended to replace independent medical judgement for treatment of individuals. 0000002834 00000 n Why not just make the rules clearer before getting rid of them altogether? Its also job security. LOL. However, if your payer still recognizes consults, they will likely require the NPI of a requesting clinician. 0000063843 00000 n CPT instructions do state that the consultation codes 99241-99245 may be used for consultations services in the ER, so that would be correct for payers that still accept those codes. E/M services that occur after the initial consultation during a single admission should be reported using non-consultation E/M codes. Health care claims payment policies are guidelines used to assist in administering payment rules based on generally accepted principles of correct coding. 0000001096 00000 n endobj And, with it, there is a consultation codes update for 2023. I dont have an answer to give them because I am getting a lot of conflicting info. Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role. [278 0 0 556 0 0 667 191 333 333 0 0 278 333 278 278 556 556 556 556 556 556 556 556 556 556 278 0 0 0 0 556 0 667 667 722 722 667 611 778 722 278 500 0 0 833 722 778 667 778 722 667 611 722 667 944 0 0 0 0 0 0 0 0 0 556 556 500 556 556 278 556 556 222 0 500 222 833 556 556 556 556 333 500 278 556 500 722 0 500 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 737] <> Privacy Policy | Terms & Conditions | Contact Us. Each payment rule is sourced by a generally accepted coding principle. I wonder if our doctors will ever get back to being able to practice medicine and not insurance OR law? Does anyone have a list of commercial insurance companies that are still accepting consult codes and one that are following medicare guidelines? .fl-builder-content *,.fl-builder-content *:before,.fl-builder-content *:after {-webkit-box-sizing: border-box;-moz-box-sizing: border-box;box-sizing: border-box;}.fl-row:before,.fl-row:after,.fl-row-content:before,.fl-row-content:after,.fl-col-group:before,.fl-col-group:after,.fl-col:before,.fl-col:after,.fl-module:before,.fl-module:after,.fl-module-content:before,.fl-module-content:after {display: table;content: " ";}.fl-row:after,.fl-row-content:after,.fl-col-group:after,.fl-col:after,.fl-module:after,.fl-module-content:after {clear: both;}.fl-clear {clear: both;}.fl-clearfix:before,.fl-clearfix:after {display: table;content: " ";}.fl-clearfix:after {clear: both;}.sr-only {position: absolute;width: 1px;height: 1px;padding: 0;overflow: hidden;clip: rect(0,0,0,0);white-space: nowrap;border: 0;}.fl-visible-large,.fl-visible-large-medium,.fl-visible-medium,.fl-visible-medium-mobile,.fl-visible-mobile,.fl-col-group .fl-visible-medium.fl-col,.fl-col-group .fl-visible-medium-mobile.fl-col,.fl-col-group .fl-visible-mobile.fl-col {display: none;}.fl-row,.fl-row-content {margin-left: auto;margin-right: auto;min-width: 0;}.fl-row-content-wrap {position: relative;}.fl-builder-mobile .fl-row-bg-photo .fl-row-content-wrap {background-attachment: scroll;}.fl-row-bg-video,.fl-row-bg-video .fl-row-content,.fl-row-bg-embed,.fl-row-bg-embed .fl-row-content {position: relative;}.fl-row-bg-video .fl-bg-video,.fl-row-bg-embed .fl-bg-embed-code {bottom: 0;left: 0;overflow: hidden;position: absolute;right: 0;top: 0;}.fl-row-bg-video .fl-bg-video video,.fl-row-bg-embed .fl-bg-embed-code video {bottom: 0;left: 0px;max-width: none;position: absolute;right: 0;top: 0px;}.fl-row-bg-video .fl-bg-video video {min-width: 100%;min-height: 100%;width: auto;height: auto;}.fl-row-bg-video .fl-bg-video iframe,.fl-row-bg-embed .fl-bg-embed-code iframe {pointer-events: none;width: 100vw;height: 56.25vw; max-width: none;min-height: 100vh;min-width: 177.77vh; position: absolute;top: 50%;left: 50%;transform: translate(-50%, -50%);-ms-transform: translate(-50%, -50%); -webkit-transform: translate(-50%, -50%); }.fl-bg-video-fallback {background-position: 50% 50%;background-repeat: no-repeat;background-size: cover;bottom: 0px;left: 0px;position: absolute;right: 0px;top: 0px;}.fl-row-bg-slideshow,.fl-row-bg-slideshow .fl-row-content {position: relative;}.fl-row .fl-bg-slideshow {bottom: 0;left: 0;overflow: hidden;position: absolute;right: 0;top: 0;z-index: 0;}.fl-builder-edit .fl-row .fl-bg-slideshow * {bottom: 0;height: auto !important;left: 0;position: absolute !important;right: 0;top: 0;}.fl-row-bg-overlay .fl-row-content-wrap:after {border-radius: inherit;content: '';display: block;position: absolute;top: 0;right: 0;bottom: 0;left: 0;z-index: 0;}.fl-row-bg-overlay .fl-row-content {position: relative;z-index: 1;}.fl-row-custom-height .fl-row-content-wrap {display: -webkit-box;display: -webkit-flex;display: -ms-flexbox;display: flex;min-height: 100vh;}.fl-row-overlap-top .fl-row-content-wrap {display: -webkit-inline-box;display: -webkit-inline-flex;display: -moz-inline-box;display: -ms-inline-flexbox;display: inline-flex;width: 100%;}.fl-row-custom-height .fl-row-content-wrap {min-height: 0;}.fl-row-full-height .fl-row-content,.fl-row-custom-height .fl-row-content {-webkit-box-flex: 1 1 auto; -moz-box-flex: 1 1 auto;-webkit-flex: 1 1 auto;-ms-flex: 1 1 auto;flex: 1 1 auto;}.fl-row-full-height .fl-row-full-width.fl-row-content,.fl-row-custom-height .fl-row-full-width.fl-row-content {max-width: 100%;width: 100%;}.fl-builder-ie-11 .fl-row.fl-row-full-height:not(.fl-visible-medium):not(.fl-visible-medium-mobile):not(.fl-visible-mobile),.fl-builder-ie-11 .fl-row.fl-row-custom-height:not(.fl-visible-medium):not(.fl-visible-medium-mobile):not(.fl-visible-mobile) {display: flex;flex-direction: column;height: 100%;}.fl-builder-ie-11 .fl-row-full-height .fl-row-content-wrap,.fl-builder-ie-11 .fl-row-custom-height .fl-row-content-wrap {height: auto;}.fl-builder-ie-11 .fl-row-full-height .fl-row-content,.fl-builder-ie-11 .fl-row-custom-height .fl-row-content {flex: 0 0 auto;flex-basis: 100%;margin: 0;}.fl-builder-ie-11 .fl-row-full-height.fl-row-align-top .fl-row-content,.fl-builder-ie-11 .fl-row-full-height.fl-row-align-bottom .fl-row-content,.fl-builder-ie-11 .fl-row-custom-height.fl-row-align-top .fl-row-content,.fl-builder-ie-11 .fl-row-custom-height.fl-row-align-bottom .fl-row-content {margin: 0 auto;}.fl-builder-ie-11 .fl-row-full-height.fl-row-align-center .fl-col-group:not(.fl-col-group-equal-height),.fl-builder-ie-11 .fl-row-custom-height.fl-row-align-center .fl-col-group:not(.fl-col-group-equal-height) {display: flex;align-items: center;justify-content: center;-webkit-align-items: center;-webkit-box-align: center;-webkit-box-pack: center;-webkit-justify-content: center;-ms-flex-align: center;-ms-flex-pack: center;}.fl-row-full-height.fl-row-align-center .fl-row-content-wrap,.fl-row-custom-height.fl-row-align-center .fl-row-content-wrap {align-items: center;justify-content: center;-webkit-align-items: center;-webkit-box-align: center;-webkit-box-pack: center;-webkit-justify-content: center;-ms-flex-align: center;-ms-flex-pack: center;}.fl-row-full-height.fl-row-align-bottom .fl-row-content-wrap,.fl-row-custom-height.fl-row-align-bottom .fl-row-content-wrap {align-items: flex-end;justify-content: flex-end;-webkit-align-items: flex-end;-webkit-justify-content: flex-end;-webkit-box-align: end;-webkit-box-pack: end;-ms-flex-align: end;-ms-flex-pack: end;}.fl-builder-ie-11 .fl-row-full-height.fl-row-align-bottom .fl-row-content-wrap,.fl-builder-ie-11 .fl-row-custom-height.fl-row-align-bottom .fl-row-content-wrap {justify-content: flex-start;-webkit-justify-content: flex-start;}.fl-col-group-equal-height,.fl-col-group-equal-height .fl-col,.fl-col-group-equal-height .fl-col-content{display: -webkit-box;display: -webkit-flex;display: -ms-flexbox;display: flex;}.fl-col-group-equal-height{-webkit-flex-wrap: wrap;-ms-flex-wrap: wrap;flex-wrap: wrap;width: 100%;}.fl-col-group-equal-height.fl-col-group-has-child-loading {-webkit-flex-wrap: nowrap;-ms-flex-wrap: nowrap;flex-wrap: nowrap;}.fl-col-group-equal-height .fl-col,.fl-col-group-equal-height .fl-col-content{-webkit-box-flex: 1 1 auto; -moz-box-flex: 1 1 auto;-webkit-flex: 1 1 auto;-ms-flex: 1 1 auto;flex: 1 1 auto;}.fl-col-group-equal-height .fl-col-content{-webkit-box-orient: vertical; -webkit-box-direction: normal;-webkit-flex-direction: column;-ms-flex-direction: column;flex-direction: column; flex-shrink: 1; min-width: 1px; max-width: 100%;width: 100%;}.fl-col-group-equal-height:before,.fl-col-group-equal-height .fl-col:before,.fl-col-group-equal-height .fl-col-content:before,.fl-col-group-equal-height:after,.fl-col-group-equal-height .fl-col:after,.fl-col-group-equal-height .fl-col-content:after{content: none;}.fl-col-group-nested.fl-col-group-equal-height.fl-col-group-align-top .fl-col-content,.fl-col-group-equal-height.fl-col-group-align-top .fl-col-content {justify-content: flex-start;-webkit-justify-content: flex-start;}.fl-col-group-nested.fl-col-group-equal-height.fl-col-group-align-center .fl-col-content,.fl-col-group-equal-height.fl-col-group-align-center .fl-col-content {align-items: center;justify-content: center;-webkit-align-items: center;-webkit-box-align: center;-webkit-box-pack: center;-webkit-justify-content: center;-ms-flex-align: center;-ms-flex-pack: center;}.fl-col-group-nested.fl-col-group-equal-height.fl-col-group-align-bottom .fl-col-content,.fl-col-group-equal-height.fl-col-group-align-bottom .fl-col-content {justify-content: flex-end;-webkit-justify-content: flex-end;-webkit-box-align: end;-webkit-box-pack: end;-ms-flex-pack: end;}.fl-col-group-equal-height.fl-col-group-align-center .fl-module,.fl-col-group-equal-height.fl-col-group-align-center .fl-col-group {width: 100%;}.fl-builder-ie-11 .fl-col-group-equal-height,.fl-builder-ie-11 .fl-col-group-equal-height .fl-col,.fl-builder-ie-11 .fl-col-group-equal-height .fl-col-content,.fl-builder-ie-11 .fl-col-group-equal-height .fl-module,.fl-col-group-equal-height.fl-col-group-align-center .fl-col-group {min-height: 1px;}.fl-col {float: left;min-height: 1px;}.fl-col-bg-overlay .fl-col-content {position: relative;}.fl-col-bg-overlay .fl-col-content:after {border-radius: inherit;content: '';display: block;position: absolute;top: 0;right: 0;bottom: 0;left: 0;z-index: 0;}.fl-col-bg-overlay .fl-module {position: relative;z-index: 2;}.fl-module img {max-width: 100%;}.fl-builder-module-template {margin: 0 auto;max-width: 1100px;padding: 20px;}.fl-builder-content a.fl-button,.fl-builder-content a.fl-button:visited {border-radius: 4px;-moz-border-radius: 4px;-webkit-border-radius: 4px;display: inline-block;font-size: 16px;font-weight: normal;line-height: 18px;padding: 12px 24px;text-decoration: none;text-shadow: none;}.fl-builder-content .fl-button:hover {text-decoration: none;}.fl-builder-content .fl-button:active {position: relative;top: 1px;}.fl-builder-content .fl-button-width-full .fl-button {display: block;text-align: center;}.fl-builder-content .fl-button-width-custom .fl-button {display: inline-block;text-align: center;max-width: 100%;}.fl-builder-content .fl-button-left {text-align: left;}.fl-builder-content .fl-button-center {text-align: center;}.fl-builder-content .fl-button-right {text-align: right;}.fl-builder-content .fl-button i {font-size: 1.3em;height: auto;margin-right:8px;vertical-align: middle;width: auto;}.fl-builder-content .fl-button i.fl-button-icon-after {margin-left: 8px;margin-right: 0;}.fl-builder-content .fl-button-has-icon .fl-button-text {vertical-align: middle;}.fl-icon-wrap {display: inline-block;}.fl-icon {display: table-cell;vertical-align: middle;}.fl-icon a {text-decoration: none;}.fl-icon i {float: right;height: auto;width: auto;}.fl-icon i:before {border: none !important;height: auto;width: auto;}.fl-icon-text {display: table-cell;text-align: left;padding-left: 15px;vertical-align: middle;}.fl-icon-text-empty {display: none;}.fl-icon-text *:last-child {margin: 0 !important;padding: 0 !important;}.fl-icon-text a {text-decoration: none;}.fl-icon-text span {display: block;}.fl-icon-text span.mce-edit-focus {min-width: 1px;}.fl-photo {line-height: 0;position: relative;}.fl-photo-align-left {text-align: left;}.fl-photo-align-center {text-align: center;}.fl-photo-align-right {text-align: right;}.fl-photo-content {display: inline-block;line-height: 0;position: relative;max-width: 100%;}.fl-photo-img-svg {width: 100%;}.fl-photo-content img {display: inline;height: auto;max-width: 100%;}.fl-photo-crop-circle img {-webkit-border-radius: 100%;-moz-border-radius: 100%;border-radius: 100%;}.fl-photo-caption {font-size: 13px;line-height: 18px;overflow: hidden;text-overflow: ellipsis;}.fl-photo-caption-below {padding-bottom: 20px;padding-top: 10px;}.fl-photo-caption-hover {background: rgba(0,0,0,0.7);bottom: 0;color: #fff;left: 0;opacity: 0;filter: alpha(opacity = 0);padding: 10px 15px;position: absolute;right: 0;-webkit-transition:opacity 0.3s ease-in;-moz-transition:opacity 0.3s ease-in;transition:opacity 0.3s ease-in;}.fl-photo-content:hover .fl-photo-caption-hover {opacity: 100;filter: alpha(opacity = 100);}.fl-builder-pagination,.fl-builder-pagination-load-more {padding: 40px 0;}.fl-builder-pagination ul.page-numbers {list-style: none;margin: 0;padding: 0;text-align: center;}.fl-builder-pagination li {display: inline-block;list-style: none;margin: 0;padding: 0;}.fl-builder-pagination li a.page-numbers,.fl-builder-pagination li span.page-numbers {border: 1px solid #e6e6e6;display: inline-block;padding: 5px 10px;margin: 0 0 5px;}.fl-builder-pagination li a.page-numbers:hover,.fl-builder-pagination li span.current {background: #f5f5f5;text-decoration: none;}.fl-slideshow,.fl-slideshow * {-webkit-box-sizing: content-box;-moz-box-sizing: content-box;box-sizing: content-box;}.fl-slideshow .fl-slideshow-image img {max-width: none !important;}.fl-slideshow-social {line-height: 0 !important;}.fl-slideshow-social * {margin: 0 !important;}.fl-builder-content .bx-wrapper .bx-viewport {background: transparent;border: none;box-shadow: none;-moz-box-shadow: none;-webkit-box-shadow: none;left: 0;}.mfp-wrap button.mfp-arrow,.mfp-wrap button.mfp-arrow:active,.mfp-wrap button.mfp-arrow:hover,.mfp-wrap button.mfp-arrow:focus {background: transparent !important;border: none !important;outline: none;position: absolute;top: 50%;box-shadow: none !important;-moz-box-shadow: none !important;-webkit-box-shadow: none !important;}.mfp-wrap .mfp-close,.mfp-wrap .mfp-close:active,.mfp-wrap .mfp-close:hover,.mfp-wrap .mfp-close:focus {background: transparent !important;border: none !important;outline: none;position: absolute;top: 0;box-shadow: none !important;-moz-box-shadow: none !important;-webkit-box-shadow: none !important;}.admin-bar .mfp-wrap .mfp-close,.admin-bar .mfp-wrap .mfp-close:active,.admin-bar .mfp-wrap .mfp-close:hover,.admin-bar .mfp-wrap .mfp-close:focus {top: 32px!important;}img.mfp-img {padding: 0;}.mfp-counter {display: none;}.mfp-wrap .mfp-preloader.fa {font-size: 30px;}.fl-form-field {margin-bottom: 15px;}.fl-form-field input.fl-form-error {border-color: #DD6420;}.fl-form-error-message {clear: both;color: #DD6420;display: none;padding-top: 8px;font-size: 12px;font-weight: lighter;}.fl-form-button-disabled {opacity: 0.5;}.fl-animation {opacity: 0;}.fl-builder-preview .fl-animation,.fl-builder-edit .fl-animation,.fl-animated {opacity: 1;}.fl-animated {animation-fill-mode: both;-webkit-animation-fill-mode: both;}.fl-button.fl-button-icon-animation i {width: 0 !important;opacity: 0;-ms-filter: "alpha(opacity=0)";transition: all 0.2s ease-out;-webkit-transition: all 0.2s ease-out;}.fl-button.fl-button-icon-animation:hover i {opacity: 1!

Baby Powder Electric Shaving, Mexican Straw Hats Manufacturers, San Antonio Housing Authority Staff Directory, Aetna Emergency Room Level Of Care Payment Policy, Articles W