Outpatient Facility Coding Alert - 2011 Issue 5
Reader Questions: Avoid Reporting 99281-99285 for Phone Call
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Article Overview
This article addresses a reader question about emergency department-related professional services and when a physician’s involvement with an ER patient may be reportable. It is aimed at coders, billing staff, and clinicians who handle E/M documentation and Medicare-related guidance, and it discusses a short scenario along with a supporting reference to CMS manual language.
Why This Topic Matters
Understanding when a phone consultation related to an ER patient is not separately reportable helps prevent inappropriate E/M billing and supports compliant claims processing.
What You Will Learn
- The general difference between a telephone-only discussion and an in-person emergency department service
- How a Medicare manual reference is used to support billing guidance in an ER-related scenario
- Why this type of question matters for E/M reporting compliance
- What information is needed before deciding whether an ER-related physician service is billable
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Physicians
- Compliance staff
Codes Discussed
Code Ranges Discussed
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