Wiki E/M Billing for Cath Transfer-Please Help!

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EmilyDingee

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Hello fellow Coders.

I have been billing for Cardiology for over a year now.

We have serveral physicians that work in several hospitals. When one of our physicains see's a patient in hospital A as a consulatation and transfers the patient to hospital B where the patient is admitted for a cath, we have been billing for the consultation and not the H&P.

Is this correct?

I would love to know how others are billing in this senerio, I am having trouble finding documemtation that explaines this!!

Thank you,
Emily
 
We have the same situation. For our office, typically the doc who sees the patient at the first hospital gets his admit/consult billed. If he/she then transfers to another facility for an intervention/procedure by another doc of the same specialty in our group, we do not bill the transfer admit. The logic is the first doc did all the work up and determined the need for the procedure/intervention. The doc receiving the patient at the 2nd facility is not doing new workup. He/she will review the 1st admit/consult and dictate an updated H&P for the 2nd facility (I think that is a JCHO requirement) but unless there are significant clinical changes, a new admit/consult is not medically necessary. That's how we handle transfers.

HTH!
 
just FYI, tho, if a cath happens on the same day as an H&P or Consult by the same MD(or one from the same group, as in the case of a transfer), the E/M codes are not billable, as they are bundled with the cath.
 
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