Baby Coder
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Hello all,
I wanted to know can a Phys bill for a 99213 in the hospital if pregnant pt was seen in ER?
I wanted to know can a Phys bill for a 99213 in the hospital if pregnant pt was seen in ER?
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Pam Warren
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99213 is not an appropriate code if the patient is under a full admit; that's an outpatient code. Also, there are other questions you need to ask yourself. Did the provider see the patient in the ED, or was the patient evaluated by an ED physician? Is your provider a specialist? Are the providers employed by the organization, and thus under the same TIN? Lots of logistics are in play, so I can't really answer your question without more details, but if the provider that saw the patient in the ED is not of the same practice/specialty as your provider then you can bill for a hospital visit if it's medically necessary; either inpatient or outpatient, depending on the admission status. Is this a consult or a transfer of care? That will drive the code you are able to bill, also.