Wiki Emergency Place of Service

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tobieforte

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My doctor wanted to charge a 99222 on a patient that he treated in the E.R. Our doctors are pulmonologists and are not E.R. doctors. He also inserted a trach at the same time. The hospital billed the POS as Emergency. I'm trying to find out since our doctor is a pulmonologist, would he get paid if I bill a 99283 ER mod visit or does he have to be an E.R. doctor to bill this charge? Or, would a 99235 observation or inpatient moderate E/M be better since he is not an E.R. doctor?? I know when a pt is emergency he is neither considered in pt or observation. Please help!
 
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My understanding, the patient has to be admitted to be a 99222 so if the patient did get admitted you can bill the 99222 mod 25 plus trach POS 21. If the reason for the pulmonologist was for resp failure or any other critical care management you can bill 99291/92 (based on time) POS 21 modifier -25 for the trach I believe 31500

You should get paid for the ER visit POS 23 but check the admit status, the critical care or consult code (admit code) might be more applicable
 
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