Cardiology Coding Alert

Question: If a cardiologist sees a patient in the ED before the patient is admitted, should I report the op consult code 9924x series or should I report the 9925x series because the patient was ultimately admitted to the hospital?

Indiana Subscriber

Answer: You should report the op consult from the outpatient series 9924x if it was done in the ED. You should use this series for consultations "provided in the physician's office or in an outpatient or other ambulatory facility, including hospital observation services, home services, domiciliary, rest home, custodial care, or emergency department," according to CPT.
 
If, however, your cardiologist is the one who decides to admit the patient to inpatient status, then you should
report all E/M services he provided on that day under the appropriate hospital admission code (99221-99223). CPT defines these codes as applying to the services provided "per day," so you would include any E/M services the cardiologist provides to this patient on the same day, in his admission service, regardless of location.