Wiki Emergency Room Codes 99281-99288

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CrysLednum

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We are having yet another discussion on the MLN Matters article - this time regarding the ER consult codes.

I was under the impression that if our doctor was asked to see a patient in the Emergency Room by the attending then he would now bill from the 99281-99288 series of codes. There is no admission, just a consult.

Another coder in our office is stating that our doctor (under the same scenario) can't bill from this group of codes because he did not arrange to have the patient meet him at the ER and not see any other doctor.

The MLN Matters bulletin, on the bottom of pg. 4 leads me to believe otherwise.
 
I think she's referring to the non-emergency scenario.

Use of Emergency Department Codes to Bill Nonemergency Services

Services in the emergency department may not be emergencies. However the codes (99281 - 99288) are payable if the described services are provided.
However, if the physician asks the patient to meet him or her in the emergency department as an alternative to the physician’s office and the patient is not registered as a patient in the emergency department, the physician should bill the appropriate office/outpatient visit codes. Normally a lower level emergency department code would be reported for a nonemergency condition

Normal ER visit:

If the emergency department physician requests that another physician evaluate a given patient, the other physician should bill an emergency department visit code. If the patient is admitted to the hospital by the second physician performing the evaluation, he or she should bill an initial hospital care code and not an emergency department visit code.

http://www.cms.hhs.gov/Transmittals/Downloads/R1875CP.pdf
 
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