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Wiki ER visits for ortho Dr

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ortho1991

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North Andover, MA
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HI All

I hope someone can help. Our ortho Dr. are called to the ED by the ED Dr. should we bill with ED codes 99281-99285 if the location is the ED or out-pt office codes? Our Dr. are not employed by the hospital they came from an out side group.

Any advice will be appreciated.

Thank you.
 
Assuming the Ortho is called in to do a consult in the ED, if the patient is Medicare, the ortho would bill using the ED codes 99281-85. If they are not Medicare and the carrier still recognizes the consult codes, you would bill with the Outpatient Consult code.

This is how I understand what Medicare has stated.

Any other thoughts?

Jodi Dibble, CPC:)
 
Unless ...

Jodi is 100% correct ... UNLESS ...

If the orthopaedist admits the patient for surgery then you would bill the appropriate Inpatient Initial Visit or Observation Admission code.

F Tessa Bartels, CPC, CEMC
 
I would only add, that if the ortho does a procedure in the ED such as a reduction or splint application, they also must use the ED E/M codes as they have taken over the care of the problem.

The ED physician has no intention if following up on this patient's problem, the ortho MD is.
 
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