Forum - Questions & Answers

Jul 27th, 2010 - einstein 1 

Consult in ER and admitted the next day different provider same group

If a physician in a group does a consult in the emergency room and then the patient is admitted by another physician in the group the next day, can the ER consult be billed even if the admitting physician is billing for the initial inpatient care the next day? Any information will be appreciated. Thank you

Jul 27th, 2010 - nmaguire   2,606 

Ed

For physician billing, each service encounter may be billed.

Jul 27th, 2010 - Codapedia Editor 1,399 

ED consult

As the non-admitting physician, you may bill for an E/M service provided in the ED. The question is: what category of service?

If the patient is in outpatient status, Medicare would have you bill ED codes, 99281--99285. CPT allows for outpatient consults.

If the patient has inpatient status, then for Medicare, bill 99221-99223 (initial hospital services codes, no modifier) and for CPT, inpatient consults.

these articles may help:
http://www.codapedia.com/-article_243_.cfm
http://www.codapedia.com/-article_455_.cfm

Jul 28th, 2010 - einstein 1 

Consult in ER and admitted the next day different provider same group

Thank you.
I just wanted to verify that both services could be billed because both physicians are in the same group and the patient was seen one day by a physician in the emergency room but the next day a physician from the same group admitted the patient.




Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association