# Hospitalist consult in the ER



## Gemini18 (Jun 3, 2009)

I have a physician who is billing a consult in the ER.  Pt came into the Convenience Care Centre and was sent over to ER with chest pain.   There is no request for consult nor does the H&P state "I was asked/called to consult".  

Physician does document he spoke with a cardiologist who will do a stress test in the morning.  Pt was given Lopressor until she is ruled out.    Physician spoke with patient and family regarding dx, tx and planning.  "Further diagnostic and management plan as the patient's clincial course and consultants input.  The patient will be discharged home once cleared by cardiology".

Is this a consult or ER visit?  It was billed as a 99244.

HPI - extended
ROS - Extended
HX - Complete

Exam - Comprehensive
MDM - High


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## LLovett (Jun 3, 2009)

I don't see how it could possibly be a consult. If the ER doc called in a hospitalists it was with the intent that the hospitalist take over the care, not for an opinion on what the ER doc should do.

Sounds like an admit to me.

Just my opinion,

Laura, CPC


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## tfischer (Jun 3, 2009)

I agree, it doesn't even sound like the criteria was even met for a consult service to be billed.


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## Gemini18 (Jun 3, 2009)

*Hospitalist consult in ER*



tfischer4 said:


> I agree, it doesn't even sound like the criteria was even met for a consult service to be billed.



Thank you.


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