Wiki Need help with ER Coding

[alma_slcd]

When coding for the emergency visit and the physician charge. I know we use for ex. 99281 but what would i use for the physician charge?

 

[mitchellde]

the physician charge is 99281-99285 depending on what the documentation states and application of either the 95 or 97 guidelines. The physician level of E&M does not have to match the facility level.

 

[alma_slcd]

?

Thanks for the quick response. I guess what i need to knw is after i code the emergency -visit charge (99281-99285) and on the same claim i have the professional fee what type of EM would i use?

 

[mitchellde]

I am unclear on what you are wanting. When a patient goes to the ER there are two entities that charge, the physician charges an E&M using 99281-99285 the facility charges a facility charge using 99281-99285. The physician typically submits his charge on a physician claim and the facility submits a facility claim. Some facilities that salary the ER providers submit both the facility and the physician charges on the same claim. If this is the case the ER for the facility side has a revenue code of 450 with the appropriate E&M and the provider has a different revenue code (981 I think but not certain please look it up), with his E&M. It just depends on what type of billing you are doing. So it is possible to have duplicate CPT codes on a facility claim but they will have different revenue codes attached.