ED Consult

Verna

Networker
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33
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A patient presents to the ED with a dog bite to the face. Our hospitalist called another physician (who is also a surgeon) to the ED to repair the wound.
The patient is Medicaid and the bill has been denied. The patient was discharged to home (no admit).

I billed 99283 for the hospitalist with a modifier -25.
I billed 99283 for the physician who repaired the wound.
And I billed 13152 for the complex wound repair (documentation supported this).

Can I get some feedback for ED consults? We have never had this happen, so I'm trying to educate myself.

Thanks so much,
Verna
 

CodingKing

True Blue
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ER physician would bill the ER E&M code. If the physician was called in to repair the wound, you would bill the surgical code only.
 

saket1577

New
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we cannot bill Complex wound repair in ED

Hi,

Hence it is ED so according to my opinion we cannot bill Complex wound repair in ED , so It might denied.

Second We will bill only those procedures which has been done by our billing physician only, Not for others.

Suppose we are billing claim for X and procedure has been done by Y, then that procedure should not get bill. I hope So.

Regards,
Saket
 
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