I'm getting confused with E/M codes now that Medicare does not pay for Consultations - can someone clarify this for me. If a patient is seen in the ER by the specialist (surgeon) and is then admitted by the ER doc, do I bill for an ED visit or In patient? Now, if my doc sees the patient and decides to do surgery and instead of documenting a consult, she documents an H&P, how would I code that? If pt is admitted, would it be an initial in patient? Or if same day surgery would it be an out patient code (ie 00202?) and if this patient were not a Medicare patient, would the H&P be a consult code or out patient or what????

Any help with this would be much appreciated - or to give me a source where I can get the correct info to determine which code set to use under all circumstances.


Jodi Dibble, CPC