What's that about?? Here is the story. My son had an appointment with a specialist within the hospital. Nothing special, nothing that was the result of an inpatient visit, nothing through their ER. When I saw the insurance breakdown from my insurance company I noticed a level 5 consult from the specialist, which was fine. I audit outpatient charts all day so I can't help myself but follow the visit as an auditor as well as a parent and it truly was a level 5.
Anyway, when I turned the page I saw a seperate E/M 99201 bill from the Hospital. I called the hospital for an explanation they said it was a "facility charge." I called the insurance carrier and they said it was an "acceptable charge at this time."
E/M codes like 99201-99205, 99211-99215 are for outpatient/office, Dr. codes only I explained. You need a billing DR number in order to charge for these codes.
Can someone please tell me what happened here? I normally audit and code outpatient visits, not hospital, so am I missing something? It just doesn't seem right.
phaliscakCPC
Anyway, when I turned the page I saw a seperate E/M 99201 bill from the Hospital. I called the hospital for an explanation they said it was a "facility charge." I called the insurance carrier and they said it was an "acceptable charge at this time."
Can someone please tell me what happened here? I normally audit and code outpatient visits, not hospital, so am I missing something? It just doesn't seem right.
phaliscakCPC