Wiki E/M scenario

[sivagurulingam]

Hello,

Any one please clarify the below scenario:

Scenario:1: Pt X has comes to ED with chest pain and identified as CHF and ED provider order the obs care and the next day the ED provider done a subsequent care and then pt has admitted to inpatient by hospitalist and on that day cardiology had a consult for CHF.

All the provider has billed with Dx : CHF

can i Bill for ED provider with initial observation care code and sebse obs care code for next day visit.For hospitalist provider Initial inpatient care. For cardiology provider appropriate consult code ?

Scenario 2: Pt X has comes to ED with chest pain and identified as CHF and ED provider order the obs care and the next day the ED provider discharge the patient from observation and admitted to inpatient by hospitalist

can i bill for ED provider with initial hospital care and next day for ED provider 99217 and for hospitalist with initial inpatient care.

Please any one help.

 

[cmartin_333]

Scenario 1 sounds correct based on the information that you have provided. ED bills initial OBS for day 1, ED bills subsequent OBS for Day 2, Hospitalist bills initial inpatient admit (not sure if it issues with concurrent care will arrive from the payer) and the Consult code if Cardiology was actually requested to evaluate the patient rather than a transfer of care.


C.Mansuy,CPC,CEMC