tci Part B Insider - 2011 Issue 5

Reader Questions: Avoid Reporting 99281-99285 for Phone Call

Question: One of our patients presented to the ER. The ER physician called our oncologist at home to discuss the patient, but the oncologist didn't go to the ER. Can I report an E/M for the ER-related service?Answer: You should not report the phone call using a separate E/M code. If the oncologist had seen the patient in the ER, then you could report an ER code (99281-99285, Emergency department visit ...).Support: Medicare Claims Processing Manual, chapter 12, section 30.6.11, states, "If the patient's personal physician does not come to the hospital to see the...

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