Wiki 2 e.r. visits different doctors

[danadee30]

Hi everyone I have question my doctor is a family physician she was called into the E.R. this weekend because the patient wanted to be admitted and she subsequently spent a lot of time with the patient but the patient did not get admitted I feel like she should be reimbursed something, but not sure if there is a CPT appropriate. I don't think you can bill out two E.R. visits even if the are different docs right? Thank you so much for your help!

Dana

 

[Cynthia Hughes]

two ER visits

Hi everyone I have question my doctor is a family physician she was called into the E.R. this weekend because the patient wanted to be admitted and she subsequently spent a lot of time with the patient but the patient did not get admitted I feel like she should be reimbursed something, but not sure if there is a CPT appropriate. I don't think you can bill out two E.R. visits even if the are different docs right? Thank you so much for your help!

Dana

While there is nothing in CPT that prohibits both doctors from billing the ED service, there is likely either a payer edit or policy that will limit the family physician to reporting either a consultation or office visit code. If the payer allows consultations and the ED physician requested advice or opinion as opposed to transferring care of the patient, a consultation code could be reported. However, if the ED physician called in the family physician to manage the patient's admission, then an office visit code is reported.

I hope that helps.
Cindy