Cardiology Coding Alert

Question: One of our patients presented to the ER. The ER physician called our cardiologist at home to discuss the patient, but the cardiologist didn't go to the ER. Can I report an E/M for the ER-related service?

Answer: You should not report the phone call using a separate E/M code. If the cardiologist had seen the patient in the ER, then you could report an ER code (99281-99285, Emergency department visit ...).

Support: Medicare Claims Processing Manual, chapter 12, section 30.6.11, states, "If the patient's personal physician does not come to the hospital to see the patient, but only advises the emergency department physician by telephone, then the patient's personal physician may not bill." You may access the manual online at www.cms.gov/Manuals/IOM/list.asp.