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patient sent to ER from Office

  1. #1
    Default patient sent to ER from Office
    Medical Coding Books
    We had a patient that was seen in our office and the doctor did an E/M on the patient and then decided to send the patient to our ER that is attached to our clinic. We are not a direct part of the hospital. Can I bill a 99213 since the patient had an evaluation in office but it was decided to send him to the ER, where he was seen?

  2. #2
    Yes, your billing is not affected by other providers out of your group/specialty. As long as the documentation supports the code you should be fine.

    I say this with the assumption this is the only time your provider saw this patient this date of service.

    Laura, CPC, CEMC

  3. #3
    yes, he did not seem him in the ER that day. Thanks so much! It gets so confusing with our doctors having hospital rights and with our hospital being connected to our clinic. I am never sure where the cross over is and how insurances view things like this.

  4. #4
    Seacoast- Dover New Hampshire
    If one of our providers sees a pt in the office and sends them to the ER we only charge what was done ie, EKG, blood draw. We are a Critical Access Hospital.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  5. #5
    Why are you not billing for the providers service?

    Laura, CPC, CEMC

  6. #6
    Seacoast- Dover New Hampshire
    With Critical Access Hospital we bill 1 claim for all encounters on 1 date of service. We all share the same tax ID.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  7. #7
    In our setting we are different tax ID numbers and actually the ER doctors are employed by Primus services,which bills completely different from the hospital so we don't run into the issue of the tax ID numbers.

  8. #8

    I guess I don't understand CAH billing then, do you not have different specialties?

    Laura, CPC, CEMC

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