Wiki PCP sees pt in ER

[tlwhlw]

How to code for the PCP visit? An established patient goes to the ER. ER physician sees the patient and requests the PCP come for consult. Patient is Medicare.

Since Medicare does not recognize consult codes, how should this be coded?99211/99215 w/correct POS, 99281/99285, or something else? Can a PCP bill ER services with an ER physician billing also?

I'm leaning towards 99211/99215 w/correct POS...per CPT, these codes are used to report E/M services in the physician's office or in an outpatient facility. Since the patient was in the ER, not inpatient yet, this would make sense.

Thank you!

 

[mitchellde]

If your physician goes to the ED at the request of the ED physician then you code it as an ER level, 99281-99285

 

[tlwhlw]

Will I need to include any modifiers, since my physician is not the treating physician, but consulting? Can more than one physician code ED codes for the same visit? I'm not familiar with ED coding!!!

 

[mitchellde]

there is no modifier, and yes more than one provider may bill an ER level on the same patient, same day. Also if you are the patient's PCP then this is not a consult, it is a request from the ER physician for you to came and see your patient.

 

[tlwhlw]

Ah!!! Thanks for your help!!! Have a great evening!

 

[cheeta3006]

Hello, can I bill a Telehealth/ Video-Audio with PCP if the patient was seen in the ER previously on the same day for the same problem?