Wiki ER Classification

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kbarron

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Is the ER considered Internal/Family Medicine? We are having a discussion regarding this. If pt is seen in the ER and then goes to a Family Practice for a new visit I am being told that pt is not new because we have the same tax id and they were seen by the ER Doc. I disagree. If you are seen by the ER doc and go to establish Primary care with family practice, you are new to the family practice. If you have information that confirms this, please let me know where I can prove this. Thanks so much.
 
I'm having this same discussion in my office....seems to me they would be a new patient as well......I'm anxious to hear the answer.(or at least input).
 
New vs Established

We have the same issue because our clinic is owned by the hospital and we share a tax id. In CPT under E/M Services Guidelines it states, "A new patient is one who has not received any professionals services from the physician or another physician of the same specialty(emphasis added by me) who belongs to the same group practice, within the past three years." My interpretation is that Family Practice and ER physicians are different specialties which if patients are seen in the ER and then come to our clinic for the first time, they are new patients. Does anyone else have other interpretations? I would be interested to know. :)
 
Subspeciality Practices

What is considered a subspecialit? I know that Gastroenterology/Cardiology are subspecialties of Internal Medicine, Thanks to Christine. This is a very interesting topic because on page 2 of CPT 2009 it shows this in the decision tree.
 
Subspecialties

An example of a subspecialist is: #1 An Internist with additional training who specializes in diseases of the blood, spleen and lymph
#2An Obstetrician/Gynecologist who provides treatment and management of patients with gynecologic cancer, including any diagnostic and therapeutic procedures necessary for the total care of the patient with the disease. Hope this helps. :)
 
ER vs Family Practice

If your ER is being covered by Family Practice physicians, then the patient is established.

If the ER is covered by physicians with an Emergency medicine specialty, then the patient might be NEW to Family Practice. (Depends on if the patient has been seen by that specialty in the last 3 years.)

F Tessa Bartels, CPC, CEMC
 
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ER Consultation

K Breeden asks: If a dr is consulted to see a pt in the ER and then the pt is discharged what code do you use. Consult or ER?

The answer is - that depends.

If the ER physician did not treat the patient at all but called your doctor to handle the case, you'll be billing the appropriate level ER code.

If the ER physician actually called for a consultation; your physician evaluated the patient and reported finding to the ER doc, then you might have a consult (Can't be sure unless I see the documentation).

F Tessa Bartels, CPC, CEMC
 
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