Wiki Emergency room consultations

[ulmer]

For Medicare billing, how is an emergency room consultation billed? Are those allowed or do you use a comparable new patient office visit code? Thank you!

 

[mitchellde]

If you are requested by the ER physician to see a patient in the ER then you bill and ER level (99281-99285) with ER as the POS

 

[AMANDACPC]

CMS is not allowing that now I was just told. suposively it started 01/01/2010 and i was never aware. I'm confused

 

[mitchellde]

No they are not allowing consults, that started 01/01/2011. They do want you bill using the ER level codes 99281-99285. It is in the revised CMS manual I can send you the copy if you need it but it is a hugh bulliten or I can cut and paste the section on emergency room visits if you would rather. Just let me know.

 

[DeeCPC]

Debra is right. If in the ER code a consult with ER codes. If the consulting provider admits the patient to the hospital then the consulting physician codes an H&P.

Here is a link: observation and ED info starts on page 4
http://www.cms.gov/MLNMattersArticles/downloads/MM6740.pdf