Wiki Seen in office, then sent to ER

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aarnold13

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We had a patient that was seen in our office for an ER follow up from a visit the evening before. The doctor saw the patient and disscussed his issues. It was decided that for Maximum pain management that the patient be sent back to the ER. The doctor marked a 99214 on the encounter but I am not sure if I am able to charge for the office visit since he is was ultimitaly handed off to ER to continue the care for that day. Does anyone have any insight on this or some sort of reference I can look into?

Thanks so very much in advance!!
Angie
 
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I can't think of a reason NOT to bill the outpatient encounter. Yes, ultimately the patient was sent to the ED, but that doesn't negate your office encounter. The MD still put in the time.

This is the best reference I've found for E/M-related questions though on quick perusal, I don't see something EXACTLY like what you're asking:

http://www.cms.gov/manuals/downloads/clm104c12.pdf

If it was me, I'd bill for the office visit as long as you have supporting documentation.
 
You can bill for the office visit unless the patient was ultimately admitted on the same day after the ER evaluation.
 
I agree with Belinda. If the doctor sends the patient to the ER and is not planning on seeing the patient again that day then yes the doctor bills for the out paient visit. The ER doctor is going to bill also for his work. If the patient gets admitted by another doctor other than the one they saw earlier then you can still bill the office visit. Only if the original doctor admits the patient then the original doctor can only bill for the initial hospital visit.

In your situation your doctor can bill for their out patient visit.

I hope this helps,
 
Does this also apply in an RHC/Urgent care setting? So, if the physician admitting is different, is it okay to bill?
 
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