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Wiki CONSULT IN THE ER

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kwrenn

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Hello. Anesthesia coder here... new to E/M coding. We recently started billing for a Plastic surgeon who sometimes performs consultations in the ER. What E/M would be most appropriate for a consult in an ER? I understand he has to meet the 3 R's for the consult, but I'm unsure of which E/M is most appropriate? As an example, a patient with a gunshot wound to the face he exams in the ER, he believes he can bill an inpatient consult code (99251-99255). However, I disagree since the patient hasn't been admitted yet. These patients are usually admitted shortly thereafter. Is it more appropriate to bill an ER E/M (99281-99285)? I understand Medicare and some commercial payors don't accept consult codes, which makes it all that more confusing. Any advice or guidance is most appreciated. Thank you.
 
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