Tameka Duncan asked:
Good Afternoon; I was wondering if someone could help me understand how to code ER Visits for a Dr. that was called in by the ER doctor.
For example; If ER doctor called in MD for a consult; MD saw pt.; gave opinion and ER Doctor made decison to send pt. home or admit.
**OR** if ER doctor called in MD for an opinion (missed AB) and MD saw pt; discharged pt. and then had them come into MD office the following morning.
**OR** if ER docotr called in MD for opinion; MD saw pt and then decided to DC home.
Also; are MDs allowed to use ER visit codes or should they use 99205-99215 codes with POS 23?
I know Medicare has it is own set of rules when it comes to consultations; but I guess my question is mainly for commercial payors and if you can address Medicare I would appreciate that too.
Answer:
You would use ER codes 99281-99285 with POS 23. This is pretty standard for the majority of payers including Medicare. There are a handful of payers who still pay for consult codes 99241-99245 but you would have to check the payer site for confirmation.
Good Afternoon; I was wondering if someone could help me understand how to code ER Visits for a Dr. that was called in by the ER doctor.
For example; If ER doctor called in MD for a consult; MD saw pt.; gave opinion and ER Doctor made decison to send pt. home or admit.
**OR** if ER doctor called in MD for an opinion (missed AB) and MD saw pt; discharged pt. and then had them come into MD office the following morning.
**OR** if ER docotr called in MD for opinion; MD saw pt and then decided to DC home.
Also; are MDs allowed to use ER visit codes or should they use 99205-99215 codes with POS 23?
I know Medicare has it is own set of rules when it comes to consultations; but I guess my question is mainly for commercial payors and if you can address Medicare I would appreciate that too.
Answer:
You would use ER codes 99281-99285 with POS 23. This is pretty standard for the majority of payers including Medicare. There are a handful of payers who still pay for consult codes 99241-99245 but you would have to check the payer site for confirmation.
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