AMA CPT® Assistant - 2005 Issue 12 (December)

Evaluation and Management: Consultations (December 2005)

December 2005 page 10c Coding Consultation:Questions and Answers Evaluation and Management: Consultations (Q&A) Question Question: Is it appropriate to report the Initial Inpatient Consultation codes (99251-99255) when a consultation is provided in the emergency department? AMA Comment AMA Comment: No. As stated in the Office or Other Outpatient Consultations guidelines, "The following codes are used to report consultations provided in the physician's office or in an outpatient or other ambulatory facility, including hospital observation services, home services, domiciliary, rest home, custodial care, or emergency department [emphasis added]." Therefore, if a consultation is provided in the emergency department...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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