I am an OB/GYN Coder and my docs sometimes see patients in Labor & Delivery if they come into the ER. I code these visits w/ E/M codes 99201-99215 because it is all outpatient. They are sent to Labor and Delivery from the ER. One of my docs seem to think that L&D is an extension of the ER and wants to code 99281-99285 because the description of an ER dept per CPT is "an organized hospital based facility for the provision of unscheduled episodic services to patients who present for immediate medical attention. The facility must be available 24 hours a day." I need some justification on my part about why we dont code ER visits if they are sent from the ER to Labor and Delivery. Any advice?