Cardiology Coding Alert

Reader Questions :

ED Visit Often Doesn't Equal ED Code

Question: Sometimes when the cardiologists see a patient in the emergency department, they dictate a consult or an H&P but select 99283. The emergency doctor also sees the patient. Which codes should I report in these situations? New Hampshire Subscriber Answer: You should report the appropriate consult and outpatient visit codes for the situation you describe. An ED visit code (such as 99283, Emergency department visit for the evaluation and management of a patient ...) would not be correct because "for any single ED patient visit, only one physician can report an ED E/M code," according to AMA's CPT Assistant (July 2002). CPT guidelines for office or other evaluation services state that "a patient is considered an outpatient until inpatient admission to a health care facility occurs." Result: If the physician's documentation meets the coding requirements of a consult, you should choose from outpatient consult codes 99241-99245, the same CPT [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Cardiology Coding Alert

View All