Wiki ED codes

[mcoria]

Can 2 physicians bill a ED code 99283 for the same date of service. One physcian treated the patient, the second Dr came in and did a consult. Im thinking the consult Dr should use 99251-99255. Please advise

 

[kak6]

99251-99255 are for in patient consults. you want 99241-99245 for out pt consults for commercial payers only. Medicare will NOT pay these CPT codes.
For Medicare use 99221-99223 initial hospital care OR 99201-99205 new pt 99212-99215 est pt. If your E&M will not substantiate an initial hospital code (you need 3 out of 3 key for initial hospital codes) you can use office visit codes which ever best describes the work performed.

and of course the other provider can bill 99281-99291 for their work performed, by the way 99283 seems a bit low for a pt that has required a consult in the ED but anything is possible.

 

[balamuruganm]

In ED we should not use 99251-99255 (Inpatient consults) but we can bill 99241-99245 for (office or out patient consults)

 

[sivagurulingam]

Hi,

For commercial we can bill with consult code, for medicare does not allow consult code.

For Medicare:
Office visit - 99201-05 or 99211-99215
ED/ER-99281-99285
Inpatient-99221-99223
Observation-99201-99205 or 99211-15
For commercial :
We can bill with appropriate consult code.