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Verna

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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
 
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.
 
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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