If I understand the scenario correctly ...
Patient presents to ER
ER doc requests surgical consult
Surgeon sees patient in ER, decides surgery required and takes patient to OR.
Patient is admitted to ? ... who is the attending - surgeon? PMD?
In the above outlined scenario, the requesting MD is the ER doc, and the consult and Decision for surgery took place in the ER. So this would be an OUTPATIENT consult 99241-45 w/ -57 (or -25) modifier, depending on whether surgical procedure was major or minor.
There would be no charge for initial inpatient admission, if the surgeon is the admitting MD because that would be global to the surgery ... The decision for surgery having occurred in the outpatient setting during the consult.
F Tessa Bartels, CPC
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