Reader Questions:
Your E/M Doesn't Have to Match the Hospital's E/M
Published on Sun Nov 15, 2009
Question: My urologist simply removes a foley catheter in an outpatient hospital exam room. Should I include this removal 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 simple foley catheter removal as part of an E/M service. These follow up visits will often be low-level visits (such as 99212, Office or other outpatient visit ...).Inpatient E/M codes would also be appropriate when your urologist performs these services in the hospital (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 an outpatient ambulatory payment classifications (APC) reimbursement. For example, if the patient has another procedure during the same encounter [...]
