AAPC - Back to school
Results 1 to 2 of 2

Thread: Charging an E&M when referring to ER

  1. #1
    Join Date
    Apr 2007

    Question Charging an E&M when referring to ER

    AAPC: Back to School
    We are a primary care/urgent care facility withouth hospital priviledges. Is it appropriate to bill an E&M when we did an examination and made the determination to refer to the ER for treatment? I was taught "no treatment means no charges for E&M". Help!! I don't want to throw money away nor do I want to bill inappropriately!!!

  2. #2

    Cool Charging an E&M when referring to ER

    I recently took my niece to an urgent care facility (also with no hospital privileges). They determined that she needed to go to an actual emergency room. I questioned whether it was appropriate to have paid a co-pay and it was explained to me that as long as they took a history, performed an examination, did some blood work and formulated a diagnosis, they were going to submit their billing for an E&M. Consequently, my niece received an EOB containing the charges for both the urgent care center AND the emergency room in which both were reimbursed accordingly.

    Hey, if your docs do the work-up and formulate a diagnosis and feel that the patient would best be served in a hospital (E.R.) setting, you should not have to eat the service rendered.

    Hope this helps!

Similar Threads

  1. Lab & Referring Provider
    By donnaacampbell@yahoo.com in forum Pathology & Clinical Laboratory
    Replies: 6
    Last Post: 03-04-2015, 11:48 AM
  2. ER/H&P double charging??
    By katiejeanne in forum Emergency Department
    Replies: 4
    Last Post: 11-09-2012, 06:58 PM
  3. Referring doctor - MRI request for H&P
    By CrysLednum in forum E/M
    Replies: 0
    Last Post: 02-07-2012, 12:16 PM
  4. Charging an E&M okay when referring out?
    By karlam in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 05-11-2009, 12:37 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.