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Thread: Medicare ED Consults

  1. #1
    Join Date
    Apr 2007

    Default Medicare ED Consults

    AAPC: Back to School
    We are a cardiology/GI practice. Currently we are billing 99211-99215 & 99201-99205 for the outpatient ED Consults for Medicare due to the new rules. I was on a webinar yesterday and Medicare is saying to bill 99281-99285 instead of consultation codes for anyone not just the ED physician seeing a patient in the ED is this new?

  2. #2
    Join Date
    Apr 2007
    Sioux Falls South Dakota


    This was addressed in MLN Matters MM6740, and they are correct. "If the ED 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."

    Cindy Mc

  3. #3
    Join Date
    Apr 2007
    North Carolina

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