For the first scenario, you say the ER calls your ENT doc "to evaluate" ... could the ER doc not be certain if scoping and removal of FB was going to be needed?
For argument's sake, let's say the child had a really small FB s/he swallowed and ENT was called to the ER to evaluate. Your doc takes a look at the Xrays, examines the child, and feels that the item will pass naturally in a day or so. He lets the ED physician know that no surgical intervention is needed, and the ED physician discharges patient w/ instructions. You'd probably be billing just a consult in that scenario.
But if, the ENT doc felt that scope w/ removal of FB was warranted, he'd proceed to the scope lab as was done in the case your present. Then you might be billing a consult (with -25 modifier) and the 43215.
So it's POSSIBLE that your physician performed a consult (I'd need to see the ER notes and what was actually requested, as well as your ENT doc's notes to be certain).
In the second case you say the ER doc called ENT "to repair." This is NOT a consult, and the basic evaluation service is included in the RVUs for the laceration repair(s).
Hope this helps.
F Tessa Bartels, CPC, CPC-E/M
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