ED Doctor Billing


Jacksonville, FL
Best answers
If a patient went into the ER and was saw by the ER Doc, and then another Doc was called in to do a consult. I know the ER Doc could Bill the 99281-99285, But will the 2nd bill a ED Visit? or a Consult Code? My confusion is can a Non-ED Doctor Bill the ER Codes or should they be billed under a admit/discharge Same day 99234-99236.
If the scond physician is requested to perform a consultation the billed services should be a consultation provided the requirements are met. If this second phyisician also, admits the patient to the hospital then only the appropriate initial hospital care code should be billed as this service includes all E/M performed that day. The guidelines in CPT are clear and spellout what can be separately billed.
Medicare guidelines state that if the ED physician requests your provider to come and evaluate the patient then it is an ER level, if the patient is admitted by your provider then you charge only the initial inpatient level.