Reader Questions:
OK if Hospital/Physician E/Ms Don't Match
Published on Sat Sep 26, 2009
Question: If the physician performs tube or catheter removals in a hospital exam room, should I include this as part of the E/M? If E/M is appropriate, will the hospital also report an E/M? And, if so, do the physician and hospital E/M codes need to match? Wisconsin Subscriber Answer: You should include tube and catheter removals as part of an E/M service. Often, follow-up visits will be lower-level (such as 99212, Office or other outpatient visit ...). Inpatient E/M codes would be appropriate in inpatient cases (for example, 99231, Subsequent hospital care, per day, for the evaluation and management of a patient ...). The hospital sometimes may have the option whether or not to report an outpatient E/M code for the outpatient ambulatory payment classifications (APC) payment. For example, if the patient has another procedure during the same encounter as the tube removal, then the hospital cannot report its [...]