Wiki N.P. ER telehealth followed by M.D. consultation in emergency room

[kayroserey@cox.net]

Greetings. I am totally confused how this should be coded and billed. Commercial insurance (MVA). Patient presents to facility ED and is seen by N.P. by telehealth. Patient had hip replacement previous week, felt pop but no pain. Next day pain and visible 'displacement.' Pelvis x-ray 2 view left hip ordered. Surgeon is called in for consult. This Surgeon is the one who did the hip replacement. Surgeon comes to ED, examines patient. orders standing x-ray and frogleg. Pain medications given and discharged home with instructions to use walker, lessen activities and follow up with surgeon. Okay, my question is this: Does the Nurse Practitioner and surgeon each get coded, one for telehealth and one for consult? or is this just one happy ED visit? I am billing for the facility, not for the providers, right? So, I'm thinking just the ED visit code. PLEASE, someone advise!

 

[kayroserey@cox.net]

Greetings. I am totally confused how this should be coded and billed. Commercial insurance (MVA). Patient presents to facility ED and is seen by N.P. by telehealth. Patient had hip replacement previous week, felt pop but no pain. Next day pain and visible 'displacement.' Pelvis x-ray 2 view left hip ordered. Surgeon is called in for consult. This Surgeon is the one who did the hip replacement. Surgeon comes to ED, examines patient. orders standing x-ray and frogleg. Pain medications given and discharged home with instructions to use walker, lessen activities and follow up with surgeon. Okay, my question is this: Does the Nurse Practitioner and surgeon each get coded, one for telehealth and one for consult? or is this just one happy ED visit? I am billing for the facility, not for the providers, right? So, I'm thinking just the ED visit code. PLEASE, someone advise!

Okay, upon further reflection, and probably because I've been studying this too hard and so just making myself more foggy brained. So, then I got to thinking since it began with our Nurse Practitioner doing a audiovisual ED visit and then the patient's doctor came in and pretty much took over, about 20 minutes for surgeon and 10 minutes for N.P.. Should this therefore be considered a split visit and since the surgeon spent most of the time should it be like 99283-FS...even though it isn't Government payor. Please help.