November 26, 2013
Our surgeon was called to the Emergency Room to see a patient in consultation. The patient was discharged from the Emergency Room. Can you tell us how to report this?
The correct category of CPT code will be dependent on payor rules. According to the 2013 AMA CPT rules, the service is a consultation and the 99241-99245 codes are reported. Report the consultation code for all payors still recognizing this category of codes.
Medicare no longer reimburses consultation service, thus a CPT code from the Emergency Department (ED) Codes (99281-99825) will be reported when the patient is seen in consultation in the Emergency Room and discharged to home.