Internal Medicine Coding Alert

Published on Sun Nov 21, 2004 PDF

Question: Our internists often treat patients in the emergency department (ED). Can they still report ED codes 99281-99285?

Washington, D.C., Subscriber

Answer: Yes - your internist should bill emergency department codes 99281-99285 when he treats a patient in the ED, as long as the documentation supports the charge.
 
In fact, the Medicare Carriers Manual (MCM), section 15507, has published guidelines concerning emergency department billing:
 
"Pay the emergency department services codes regardless of whether the physician is assigned to the emergency department. Any physician seeing a patient registered in the emergency department may use these codes."
 
Billing tip: When charging for ED services, make sure you report 23 as the place-of-service code on claim form CMS-1500.
 
Appeal tip: If a commercial insurer denies your ED claim, you should appeal this denial based on MCM's guidelines.