Wiki New E&M for specialty providers

[Always24]

Patient was seen in our ER which is a department of our clinic and we share the same tax id, can a specialty provider, ie Pediatrician, charge a new patient E&M after the visit to the ER?

 

[LLovett]

As long as they are credentialed as different specialties yes. Which the ER provider should be different than the Peds.

I will say though, we had a situation where I used to work where our Peds rotated thru our urgent care. So we had to be careful, even though the patient was seen in urgent care the provider was still peds so they were established. Probably not the case in your ER but thought I would mention it just incase.

Laura, CPC, CPMA, CEMC

 

[Always24]

Thank you for your reply. We were told because we share the same tax id number that we are not able to bill new patient visit when the patient was seen in our ER but we are not able to obtain anything in writing. We have taken it to our corporate compliance team. Thanks!