Wiki ER to ER

[Ruthannpardo]

Question: How would you bill the following scenerio: St. Hospital A sees a patient in the ER and then sends the patient to St. Hospital B (sister hospital) for surgery. The surgical charge (surgery) and the observation charge (observation care) is billed by St. Hospital B. Does St. Hospital B get an ER code as well?

 

[thomas7331]

It would depend on the specific circumstances, but generally no, the second hospital wouldn't bill an ER charge if the emergency evaluation had already been performed at the first hospital and the determination was already made that the patient needed surgery - there be no need to start the evaluation all over again. The receiving hospital can't bill an ER charge just by having the patient pass through the ED on their way to surgery. However, if the patient is admitted to observation, the hospital can bill HCPCS code G0379 for a direct admission to observation from outside the facility.

 

[Ruthannpardo]

Can you remind me, if a patient comes in at 9pm to the ER, at midnight, is it another ER charge? And, if not, when does a 'second er' charge come in to play? Thank you for your help! - no critical care, e/m, obs or other billed on the 'second' date of service.

 

[thomas7331]

Can you remind me, if a patient comes in at 9pm to the ER, at midnight, is it another ER charge? And, if not, when does a 'second er' charge come in to play? Thank you for your help! - no critical care, e/m, obs or other billed on the 'second' date of service.

No, only one ER charge. You can bill a second ER charge only if the patient is discharged (or leaves AMA) and then comes back and presents again to the ER.

 

[Ruthannpardo]

Ah, yes, I do remember now. Thank you again for your help.