Wiki Intro OR consult!


Ashland, VA
Best answers
We had one of our doctors walk into the OR to visualize the gynecologic anatomy and did not see a sourse of abdominal pain. How can we bill for this or if we can?
I'm confused ...

So your physician was CALLED in by the operating surgeon for his/her advice/opinion?

If there is a written report I would code this as 99499 - Unlisted E/M. I would base my fee on the lowest level inpatient consultation (there really is no history that can be taken, as the patient is anesthetized, there is only an extremely limited "exam" from your description, and who know what kind of medical decision making there is ...)

Hope that helps.

F Tessa Bartels, CPC, CEMC
This one is tricky as there area a few different factors to consider. It will come down to the patients status in most cases. If the patient is in an inpatient status you could potentially bill Subsequent Hospital Care 99231/32 depending on documentation. I'm betting this was an outpatient, so you'll have to go with FTessa's suggestion on 99499. Lastly, if Same Group and Specialty add both DR's E/M documentation together and bill to the appropriate level.

For explanation of how you might be able to use the Subsequent Hospital Care code see attachment - MLN:MM7405.


  • EM Consult Clarificaton.pdf
    100.2 KB · Views: 2