Wiki Coding ER visits with Initial hospital care

[alwin928]

Need assistance with ER coding with initial hospital care.

CPT says basically that anything that happens prior to admit on the same calendar day is lumped into the initial hospital care code. Is that only if the same physician treats the patient prior to admit or can one physician, who treated the pateint in the ER, bill the an ER code and an another bill the initial hospital care code? Both physicians are in the same group. thanks in advance.

 

[FTessaBartels]

Same group, same specialty?

If they are in the same group and of the same specialty they are considered the same doctor, and you roll everything into the initial hospital visit code. In our practice, we would give to the doctor who saw the patient first. Some practices go by the physician who actually admitted. Still others look at the documentation and give it to the one who did the most work.

If they are in the same group but of DIFFERENT specialties (e.g. Emergency Medicine and Cardiology) they each code for what they did.

Hope that helps.

F Tessa Bartels, CPC, CEMC