E&M Billed after ER Hospital Visit

A new patient was seen in the hospital ER for an orbit fracture and referred to one of our plastic surgeons. We saw him as a new patient in office (surgical consult)and billed 99204 to his private insurance. It was denied as part of the global service although it was his first time to be treated by our group.

Jul 21st, 2011 - jschmutz 323

re: E&M Billed after ER Hospital Visit

You'll need to get more information from the payer - the denial doesn't make sense.

Jul 21st, 2011 -

re: E&M Billed after ER Hospital Visit

What happened in the ER? if it was just a consult, then your office visit should be 99214 since patient is established. If you did a surgery in the ER, then there may be a global period.

Jul 22nd, 2011 - dcrenshaw 1

re: E&M Billed after ER Hospital Visit

Our group did not see the patient in the ER. Hospitalists ordered a CT and diagnosed the orbit fracture. The patient was referred to our group for increasing sinus pressure and dizziness. Thanks

Jul 23rd, 2011 -

re: E&M Billed after ER Hospital Visit

Well, i agree - that makes absolutely no sense, unless patient has some bizarre insurance that makes a global payment for all care related to a problem, but I have never heard of that happening...yet