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Gastroenterology Coding Alert

Reader Question:

Observe Date of Admission to Correctly Report ER Patient

Question: One of our patients came through ER at 1 p.m. in the afternoon and was admitted on the same day at 4.30 p.m. Our gastroenterologist saw the patient at 10.30 p.m. the same night. I used 99254 with place of service (POS) as inpatient. But my colleague is of the opinion that it should be billed using 99285 as the patient came through the emergency room although our gastroenterologist did not see the patient in the ER. Tell me who is correct. Maryland Subscriber Answer: If a patient is admitted into the hospital after an outpatient consultation (such as office, or emergency department) but the patient is not seen on the unit on the same day of admission, you have to report the relevant outpatient consultation codes (99241- 99245, Office consultation for a new or established patient, which requires these 3 key components...). However if the patient is seen [...]


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