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Consultation

Darshna Posted Mon 06th of March, 2017 15:27:57 PM
My provider does consultation in Hospital(emergency department) at the request of the emergency room doctor. Which CPT code will be covered by the insurance?
SuperCoder Answered Tue 07th of March, 2017 05:11:03 AM

Hi,

 

If you are asked to see the patient in the ER and the patient’s insurance company accepts consultation codes and you do not admit the patient to your service, you can bill the service as an outpatient consultation visit. Outpatient consultation codes are 99241-99245. (This is normally for commercial carriers).

 

If you see the patient in the ER at the request of another provider and the patient’s insurance company does not accept the outpatient consultation codes and you do not admit the patient to your service, you can bill the visit as a 99281-99285. (This is normally Medicare and Medicaid).

 

 

Thank you!

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