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Wiki procedure w/no E/M level

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alices

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Can someone please point me in the right direction, I am an ed coder for both pro-fee and facility and we are a teaching hospital, we don't have shared visits, I had a chart where Dr. A started the case and did a laceration repair, Dr. B came and took over the case and discharged the pt so I gave the E/M to DR. B and just coded the laceration repair for Dr.a, I sent the pro-fee charge over to the billing co and they sent it back wanting an E/M level for Dr. A, I thought there was a guideline that if a Dr. does only a procedure that he could bill for that w/o an E/M, wouldn't that apply to this situation? or no?..thanks for any and all help...alice
 
You are correct. You can only bill one e&m per visit. Each group normally has their own rules. Normally, whoever performs the history and exam and provided the medical decision making which included sewing the laceration would typically bill for both services. And the physician that just completed the visit and discharged the patient performs this as a cortesy to the first provider. This happen alot in the ER and so I would routinely bill it all under provider #1 and give no credit to provider #2.
 
procedure no e/m level

Thank you, I would like to be able to give to dr. a because he really did everything, but our hospital has stated that who ever discharges the pt gets the charge.
can you tell me where I can find the guideline for that senario? I have looked but I must not be looking right because I can not find that specific guideline...thanks for all your help..alice
 
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