Emergency Room Professional Billing


Grayson, KY
Best answers
A facility has a Psychiatric Distinct Part Unit which is an IP unit of the hospital however located in a separate building on campus. Due to internal workflow when there are acute medical needs these patients are sent to the Emergency Room at the facility. There are no facility E/M levels as these are Inpatients. My question pertains to the Emergency Room Physician Professional Billing. Would it be compliant for the ED physician to bill the insurance for his/her professional services? (If the patient condition warranted further medical treatment then the Distinct Part Unit admission would be discharged and new account for the medical. DPU has different reimbursement). (if the pt condition didn't warrant acute medical attention then the pt would be sent back to the DPU and that admission would continue).