Wiki Medical Coder

[kjhos@verizon.net]

Where is the written rule stating that a specialist or a PCP can NOT bill services in the Emergency Room place of service. (Patient only seen in the ER, not admitted, not in Observation)
thanks

 

[mhstrauss]

Where is the written rule stating that a specialist or a PCP can NOT bill services in the Emergency Room place of service. (Patient only seen in the ER, not admitted, not in Observation)
thanks

I'm not sure you'll find this specifically in writing, except for from each individual payer. Depends on whether or not they follow Medicare's "no consult" rule. See the links below (Medicare DOES allow ER services for all providers that see the patient, not just the ER doc.):

http://bulletin.facs.org/2013/02/coding-for-hospital-admission/

https://www.cms.gov/Outreach-and-Ed...k-MLN/MLNMattersArticles/downloads/mm6740.pdf