Wiki Hospital billing E/M ?

[BJTRAISTER]

We have a PA that is going to be H&P's for patients prior to having surgery. The PA will be doing them in our facility - can the hospital bill for the H&P? I always thought that was a professional only charge.

Thanks for any guidance you can provide.

 

[mitchellde]

are you talking billing for outpatient facility?
If so the outpatient facility will submit an E&M charge for the clinic rev code 510 but it is not for the H&P it is for the use of the clinic even though it may be the same code as a physician uses it means different info to the facility.
If you are talking inpatient then no the facility does not use CPT codes at all for inpatient encounters.

 

[BJTRAISTER]

It would an outpatient visit - and thank you for the information - this is a new line of business for us and not something I am familiar with.

 

[mitchellde]

The facility must have criteria established to determine the visit level for their facility. Every facility can be different as they are allowed to establish it themselves. look up the rules for APCs. If you need more help you can send me a PM.