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ER Visit vs. Admission Visit

  1. Default ER Visit vs. Admission Visit
    Medical Coding Books
    Has anyone come across this...a physician seeing the pt in the emergency room - charging an ER visit under one tax id # then the same physician admits the pt under a different tax id #. Is this physician able to charge for both services since there are 2 tax id #? Usually if the physician sees the pt in the ED then admits, the ED visit is not charged. Any info would be appreciated.

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default Doesn't sound right to me
    I hate to be dramatic, but this sounds like outright fraud.

    CPT specifically tells us that if the patient is admitted in the course of another encounter (example: emergency room) that you code ONLY the initial hospital visit.

    F Tessa Bartels, CPC, CEMC
    Last edited by FTessaBartels; 12-10-2009 at 02:47 PM.

  3. #3
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by thebis View Post
    Has anyone come across this...a physician seeing the pt in the emergency room - charging an ER visit under one tax id # then the same physician admits the pt under a different tax id #. Is this physician able to charge for both services since there are 2 tax id #? Usually if the physician sees the pt in the ED then admits, the ED visit is not charged. Any info would be appreciated.
    I'm trying to wrap my head around this scenario.....wow....

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