Wiki Hospital "consults" and ER visits

[Orthosports]

Two scenarios that I need reassurance with as my bosses think I am coding incorrectly - - -

If the doc on call sees a patient in the hospital in consult at the request of the admitting doctor - am I using 99223? On the same lines, if the doc admits a patient and sees him in consultatiion is it the same code and are we using a modifier to indicate such like A1?

Secondly, if a patient is seen in the ER by the doctor on call are we using the 99283 family or using 99203?

Thanks so much.

 

[emcee101]

Question 1 - 9922x faimly would be correct dependent on insurance. If the insurance still pays consult codes, I would use those codes (9925x) instead as long as the consult is supported. If the doctor admists you would still bill for the admission day with the appropriate initial hospital care codes, using 9922x and AI as you stated, and the following days with the subsequent hospital day code.

Qurestion 2 - 9928x family is correct. The service is being performed in the ED, so you should bill with the ED codes.

What are your bosses saying you should be doing instead. your code choice seems correct all around?