If the emergency dept. physician requests that another physician evaluate a given patient, the consulting physician should bill an emergency department visit code (99281-99285). If the patient is admitted to the hospital by the consulting physician performing the evaluation, he or she should bill an initial hospital care code and not an emergency department visit code (99221-99223 and appending the AI modifier). As for your question regarding observation codes.. A patient is considered an outpatient until admission to a health care facility occurs. Therefore depending on the documentation i would code either 99221-99223 or new or established coded 99201-99205; 99212 to 99215 code set...
hope this helps,
Cheryl Anderson, LPN, CPC, CEMC,