Wiki ER visit by primary care dr

[jkubica]

Patient calls primary dr with issues and is told to go to the ER. The Dr meets the patient at the ER and documents visit. Before the PCP arrives at ER the patient is seen by ER Dr. How would the visit by the PCP be coded as it is not a consult since it was the call from the patient that initiated it?

 

[jimbo1231]

Pcp

That happens quite a bit. ED docs are not always big fans of PCPs meeting patients at the ED since that becomes 0 revenue to the ED docs, although the hospital can bill for the vist.
Did the PCP also do an E&M service on site? Since the site of service is the ED the PCP would also bill with 99281-5 code. I do think either the PCP or ED doc could get a denial from the payer since it would be hard to argiue medical neceesity for both services. And the ED doc did what they are supposed to do which is treat the patient. But you can bill for your service and see what happens.

Jim S.