ER visit vs Consult

kibbit99

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If our physician sees a patient in the ER before another physician admits the patient on the same day, do we bill the 9924* or 9925*? I hope this question makes sense. Can anyone enlighten me regarding this?

What code would the next day be if it is the 9924*?

If you bill the 9924* code, would the next day seen be 9923* or 9925*?

I keep getting mixed answers from other employees and I want to make sure we are billing correctly.

Thanks,

Kim
 

LLovett

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Is it truly a consult in the ER? If it is a consult and the patient is not yet admitted it would be 9924X.

If they are following up once the patient is inpatient you would go to subsequent care 9923X.

The fact that they are following up makes me think it may not be a consult at all, but a transfer of care.

Laura, CPC
 

kibbit99

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Our physician did not indicate if it was before admission. I have to sort this one out with some research. Looks like he was the on-call Dr. and seen the patient before patient was admitted for another reason.

There was no transfer of care established at this moment.

Thank you for your help. I hate second guessing when other people give you some input.

Kim, CPC
 
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