Wiki Skeeley

[skeeley]

ER coding

Help please. When you are seeing a patient in the ER as a new pt (consult) would you charge an ER code or Outpatient consult code? The notation under ER coding states it does not matter if it is a new patient or established patient. Yet under consults it states to use Outpatient consultation in ER setting. I find many conflicting articles on this subject. Any help would be appreciated.

 

[ksd]

The codes you use for the emergency department would be 99281-99285. If critical care was rendered and meets the criteria then the codes would change to 99291 etc. You will on occasion as criteria warrants, use codes 99217-99220 and 99234-99236. But, the majority for an ER visit will be 99281-99285.

 

[skeeley]

Thanks. I understood it that way as well. I am being told to use consult codes instead when we are seeing patients in the ER setting. (When they are new patients and not Medicare) Just trying to figure out the difference in using the outpatient consult for ER and using the ER codes.

 

[ksd]

When a patient is seen in the emergency department and put into observation status then they will fall under 99217-20, 99224-6, and 99234-36 codes. But if the patient is seen and evaluated then you bill for any procedures done and the level of the visit 99281-85. Of course this is not 100% s patient may have critical care done for example.