Emergency room CPT coding

My question is this... When our ENT physicians see a patient in the emergency room I was always told to use the 9920X or 9924X series (office or outpatient facility; emergency room)... But I am now being told by an insurance company that we should be billing with CPT codes 99281-99285. Can someone tell me what is accurate?

Thanks a bunch!
Sheri

E/M site of service

Depends on the circumstances. If seen in ED and discharged by MD, then 99281-99285 is appropriate. If seen and admitted, an admit code (inpt or obs). If a consult was requested, the 99241-99245 series. If MD seeing patient because the ER is more convenient for him, then code series 992xx series.

Emergency room CPT coding

So the 99281-99285 CPT codes aren't necessarily ONLY for the doctors employed in the ER? These codes can be used by oncall doctors coming to see a patient in the emergency dept.?

Emergency Room CPT coding

Seth Canterbury has written a great article for Codapedia on the use of ED codes by non ED Department MD's. You can read it by searching for ED or even Seth in the search box. (above look it up!)

He describes the differences between CPT and CMS policy on this topic.