ED Coding and Reimbursement Alert

Question: A patient in labor is admitted directly to the labor and delivery ward without ever going to the ED. During her delivery, she goes into atrial fibrillation, and the attending physician calls in the ED physician to consult and verify that she is in atrial fibrillation. After stabilization, the patient is transported to another facility. Which E/M code should I use for the ED physician's work? Iowa Subscriber Answer: Your ED physician most likely provided a consultation when confirming that the patient in delivery went into atrial fibrillation (an abnormal, irregular heart rhythm with chaotic generation of electrical signals in the atria of the heart). You should report the E/M codes for initial inpatient consultations for new or established patients (99251-99255) if documentation of your physician's work meets the following requirements:
The attending physician (or other appropriate source) requests the consultation of your physician, and the patient's medical record documents that request.
Your physician performs a history, physical exam and an assessment of the patient.
Your physician reports back to the referring one. You should also separately code any procedure the ED physician performs and appropriately documents.