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Thread: Urgent care

  1. #1

    Default Urgent care

    AAPC: Back to School
    If patient comes to UC for treatment of a laceration is it appropriate to bill an E/M level in addition to the repair?

  2. #2
    Join Date
    Apr 2007
    North Carolina


    Laceration repairs do include an evaluation service. An E/M could be justified if the physician had to determine the extent of the injury (example-head injury) and/or whether there is any pertinent underlying medical condition (example-diabetes) that could complicate the procedure. If it is a simple repair that does not require a separate, identifiable service, I would only code the laceration repair.

  3. #3

    Question Urgent care

    Rebecca -

    We are a facility based UC, but we operate more like a free standing. We need to comply with EMTALA does this change your answer at all?

  4. #4
    Join Date
    Apr 2007
    North Carolina


    I don't know that it does. The of purpose of EMTALA is to prevent hospitals from rejecting patients, refusing to treat them, or transferring them to "charity hospitals" or "county hospitals" because they are unable to pay or are covered under the Medicare or Medicaid programs. In my mind, these are two separate issues. EMTALA protects the patients well being. That's not to say that the assessment doesn't play a role in the documentation but I think this would become a case by case issue. I don't see EMTALA being a resource for physicians to bill a E/R visit with every repair unless it's medically necessary and supported by documentation. I would like to hear what others have to say.......................

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