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ER Classification

  1. #1
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default ER Classification
    Exam Training Packages
    Is the ER considered Internal/Family Medicine? We are having a discussion regarding this. If pt is seen in the ER and then goes to a Family Practice for a new visit I am being told that pt is not new because we have the same tax id and they were seen by the ER Doc. I disagree. If you are seen by the ER doc and go to establish Primary care with family practice, you are new to the family practice. If you have information that confirms this, please let me know where I can prove this. Thanks so much.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  2. Default
    I'm having this same discussion in my office....seems to me they would be a new patient as well......I'm anxious to hear the answer.(or at least input).

  3. #3
    Location
    Kingsport, TN
    Posts
    149
    Default New vs Established
    We have the same issue because our clinic is owned by the hospital and we share a tax id. In CPT under E/M Services Guidelines it states, "A new patient is one who has not received any professionals services from the physician or another physician of the same specialty(emphasis added by me) who belongs to the same group practice, within the past three years." My interpretation is that Family Practice and ER physicians are different specialties which if patients are seen in the ER and then come to our clinic for the first time, they are new patients. Does anyone else have other interpretations? I would be interested to know.

  4. #4
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default ER Classification
    Any takers on this?
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  5. #5
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default Subspeciality Practices
    What is considered a subspecialit? I know that Gastroenterology/Cardiology are subspecialties of Internal Medicine, Thanks to Christine. This is a very interesting topic because on page 2 of CPT 2009 it shows this in the decision tree.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  6. #6
    Location
    Kingsport, TN
    Posts
    149
    Default Subspecialties
    An example of a subspecialist is: #1 An Internist with additional training who specializes in diseases of the blood, spleen and lymph
    #2An Obstetrician/Gynecologist who provides treatment and management of patients with gynecologic cancer, including any diagnostic and therapeutic procedures necessary for the total care of the patient with the disease. Hope this helps.

  7. #7
    Default ER
    If a dr is consulted to see a pt in the ER and then the pt is discharged what code do you use. Consult or ER?

  8. #8
    Location
    Kingsport, TN
    Posts
    149
    Default
    I would check the documentation. Does it meet the requirments for a consultation?

  9. #9
    Location
    Milwaukee WI
    Posts
    4,466
    Default ER vs Family Practice
    If your ER is being covered by Family Practice physicians, then the patient is established.

    If the ER is covered by physicians with an Emergency medicine specialty, then the patient might be NEW to Family Practice. (Depends on if the patient has been seen by that specialty in the last 3 years.)

    F Tessa Bartels, CPC, CEMC
    Last edited by FTessaBartels; 03-06-2009 at 05:23 PM.

  10. #10
    Location
    Milwaukee WI
    Posts
    4,466
    Default ER Consultation
    K Breeden asks: If a dr is consulted to see a pt in the ER and then the pt is discharged what code do you use. Consult or ER?

    The answer is - that depends.

    If the ER physician did not treat the patient at all but called your doctor to handle the case, you'll be billing the appropriate level ER code.

    If the ER physician actually called for a consultation; your physician evaluated the patient and reported finding to the ER doc, then you might have a consult (Can't be sure unless I see the documentation).

    F Tessa Bartels, CPC, CEMC

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