Wiki Help E/m

[Earnose]

Two questions-
1.My Doctor saw a patient in the office and sent him to the ER to be admitted but he did not directly admit him so how should i code this. If he is not the admiting it should be an office visit right?

2. Do only Emergency Department Physicians use emergency department codes or can any other physician that evaluates the patient while in the ER use the emergency department visit codes. Example is my doctors are specialist and not ER doctors. The way i read it is yes they should use ED codes if they our on call and evaluate a patient in the ER.

 

[RebeccaWoodward*]

Two questions-
1.My Doctor saw a patient in the office and sent him to the ER to be admitted but he did not directly admit him so how should i code this. If he is not the admiting it should be an office visit right?

2. Do only Emergency Department Physicians use emergency department codes or can any other physician that evaluates the patient while in the ER use the emergency department visit codes. Example is my doctors are specialist and not ER doctors. The way i read it is yes they should use ED codes if they our on call and evaluate a patient in the ER.

Question 1-Answer-If your physician or a member of his specialty group was not the admitting provider, you would bill for the office visit.

Question 2-Answer-If the ER physician calls your physician to the ER to evaluate a patient and your physician does not admit the patient, your provider would bill for a ER visit

"Emergency Department Physician Requests Another Physician to See the Patient in Emergency Department or Office/Outpatient Setting"

"If the emergency department physician requests that another physician evaluate a given patient, the other physician should bill an emergency department visit code. If the patient is admitted to the hospital by the second physician performing the evaluation, he or she should bill an initial hospital care code and not an emergency department visit code." (Medicare Chpt 12)

However...

If this was a NON-Medicare patient, it's possible that your specialist could bill for an outpatient consultation (99241-99245) if the requirements are met.