Wiki Ortho Billing E/M in ER


Norfolk, NE
Best answers
Our ortho doc was asked by the ED doc to see a patient in the ED....the ED doc billed out for the facility E/M (9928*) and we were always told to bill out the outpatient (99201-99215) E/M for the ortho doc if it wasn't an insurance company that took consult codes. But after researching we are finding that we should be billing the ED E/M's as well as ED doc. Can somebody help me out on this?! TIA! Kerry :)
Bill the ED codes if they do not accept the consults. We have been doing this for years w/o problem :) I don't have documentation to prove its the right route but works for us here in Washington state.

Kelsey, CPC
It is stated in the MCM manual that you use the ER codes when the ER physician requests your physician to see the patient, these were never suppose to be billed as a consult only as ER.