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Multiple Physicians, Same Patient in the ER

  1. Default Multiple Physicians, Same Patient in the ER
    Medical Coding Books
    Is there any written material that clearly states that if a specialist is called into the Emergency Room and it is not a consult, that both the ER physician and the specialist can charge ER codes?

    When I took my CPC in 2006 the manual was clear that "when a patient is seen by two physicians in the ED, the ED evaluation and mangement code is usually only employed by the emergency department physician to describe the level of service. The other physician would use a code from the E/M catagory that best describes the respective services(consultation or new/established patient office/outpatient."

    Thank you,

  2. #2
    Hi Marci:

    30.6.11 - Emergency Department Visits (Codes 99281 - 99288)
    (Rev. 1875, Issued: 12-14-09, Effective: 01-01-10, Implementation: 01-04-10)
    A. Use of Emergency Department Codes by Physicians Not Assigned to Emergency Department
    Any physician seeing a patient registered in the emergency department may use emergency department visit codes (for services matching the code description). It is not required that the physician be assigned to the emergency department.

  3. Default
    Can this be used for Commerical payors as well?


  4. #4
    Columbia, MO
    yes commercial as well. It is not a consult because you cannot meet all the requirements of a consult. Yes you have the request, but the ER physician is not asking you to RENDER back to him a decision or an opinion about some issue he is unsure about, and your physician does not provide then a formal letter of REPORT that goes back to the ER physician detailing his findings and recommendations. therefore it is an ER level when the ER physician calls your physician in. If your physician told the patient to meet him in the ER and the patient is not triaged as an ER patient then it would be office level codes.

    Debra A. Mitchell, MSPH, CPC-H

  5. Default
    Thank you so much for your help.

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