Wiki surgeon E/M in the emergency dept

[sbetts]

A patient comes to the ED and the general surgeon on call is called down to evaluate the patient. The surgeon decides to admit the patient for surgery. Would it be correct to code the surgeon's E/M with an ED code (99281-99285)?

Thank you!

Shena Betts, CPC

 

[Lesainc]

Would it make more sense to code it as the admit with the Decision for surgery modifier and the pos would be the admit location?

 

[sbetts]

I don't know, would it? The actual service took place before the patient was admitted. Do you know if there is a guideline from Medicare on this specific scenario?

thanks,
Shena Betts, CPC

 

[RebeccaWoodward*]

F. Emergency Department Physician Requests Another Physician to See the Patient in Emergency Department or Office/Outpatient Setting

If the emergency department physician requests that another physician evaluate a given patient, the other physician should bill an emergency department visit code. If the patient is admitted to the hospital by the second physician performing the evaluation, he or she should bill an initial hospital care code and not an emergency department visit code.

http://www.cms.gov/manuals/downloads/clm104c12.pdf

Section 30.6.11 F

 

[rbeaver]

I Agree

I was just reading the article on the American College of Surrgeons Division of Advocacy and Health Policy and that is what it said but this is the Medicare guidelines. Thanks for the interesting answers.

 

[EmilyLitella]

As Rebecca showed, it all "rolls into" the admit.

 

[sbetts]

Thank you! Rebecca, that is exactly what I was looking for.

Shena