• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Charging an E&M when referring to ER

Create Wiki
K

karlam

Networker
Messages
36
Location
Highland Springs, VA
Best answers
0
We are a primary care/urgent care facility withouth hospital priviledges. Is it appropriate to bill an E&M when we did an examination and made the determination to refer to the ER for treatment? I was taught "no treatment means no charges for E&M". Help!! I don't want to throw money away nor do I want to bill inappropriately!!!:confused:
 
I recently took my niece to an urgent care facility (also with no hospital privileges). They determined that she needed to go to an actual emergency room. I questioned whether it was appropriate to have paid a co-pay and it was explained to me that as long as they took a history, performed an examination, did some blood work and formulated a diagnosis, they were going to submit their billing for an E&M. Consequently, my niece received an EOB containing the charges for both the urgent care center AND the emergency room in which both were reimbursed accordingly.

Hey, if your docs do the work-up and formulate a diagnosis and feel that the patient would best be served in a hospital (E.R.) setting, you should not have to eat the service rendered.

Hope this helps!
 
You must log in or register to reply here.
Top