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Thread: Emergency room consultations

  1. #1

    Default Emergency room consultations

    AAPC: Back to School
    For Medicare billing, how is an emergency room consultation billed? Are those allowed or do you use a comparable new patient office visit code? Thank you!

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    If you are requested by the ER physician to see a patient in the ER then you bill and ER level (99281-99285) with ER as the POS

    Debra A. Mitchell, MSPH, CPC-H

  3. #3


    CMS is not allowing that now I was just told. suposively it started 01/01/2010 and i was never aware. I'm confused

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    No they are not allowing consults, that started 01/01/2011. They do want you bill using the ER level codes 99281-99285. It is in the revised CMS manual I can send you the copy if you need it but it is a hugh bulliten or I can cut and paste the section on emergency room visits if you would rather. Just let me know.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5


    Debra is right. If in the ER code a consult with ER codes. If the consulting provider admits the patient to the hospital then the consulting physician codes an H&P.

    Here is a link: observation and ED info starts on page 4

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