Wiki Office Visit to ER

[LeaHarris]

If a patient presents for an assessment (sometime this includes stat labs) for an issue and my provider completes the assessment then determines that the patient will receive more expedited care in the ER, can my provider still charge for an E/M for their assessment?

Thank you,

Lea

 

[twizzle]

If a patient presents for an assessment (sometime this includes stat labs) for an issue and my provider completes the assessment then determines that the patient will receive more expedited care in the ER, can my provider still charge for an E/M for their assessment?

Thank you,

Lea

Yes, your provider would be able to bill an appropriate E/M office visit for this scenario. Don't forget, for office visits using the 2021 guidelines you will see under high risk 'decision regarding hospitalization' which could apply in this situation.

The patient does not need to be admitted for this to be utilized - it is based on your provider's decision that the patient need a higher level of care by going to the ER. I had a couple of cases where mid-levels (NPs) saw patients with sky high blood pressures like 240/165 which clearly needed to be addressed urgently and so they were sent to the ER for expedited care. This could qualify as a level 5 for a chronic problem (assuming they already had hypertension) with severe exacerbation and high risk for hospitalization; of course the quality of documentation would determine the final level.

 

[kimr011@hotmail.com]

Does the same instruction apply if the patient is transported to the hospital from the office?
Can we still bill out an office visit when patient was admitted to hospital from office?

 

[Orthocoderpgu]

Does the same instruction apply if the patient is transported to the hospital from the office?
Can we still bill out an office visit when patient was admitted to hospital from office?

If the same physician performed both the E/M and the hospital admit, then no. Which is very unlikely.