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evaluation and management at ASC

  1. #1
    Default evaluation and management at ASC
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    One of our doctors had a patient come in for screening colonoscopy. The patient showed heart block when hooked up to the cardiac monitor. The patient did not receive anesthesia and no IV was started. Our doctor evaluated the patient and arranged transport to the ER for further evaluation. Our group did not admit.

    Can we bill for E/M with ASC as the place of service?



  2. Default
    I believe em code 99291 would be most appropriate providing that the physicians eval met the time frame of 30-74 minutes spent with patient prior to transport. After 74 min each increment of 30 minutes thereafter would be coded with 99292.

  3. Default
    heart block does not automatically equate to critical care. If the patient actually did meet the guidelines for CC, then code it. But time is 99291 for the 1st hour and 99292 for each additional 30 minutes. If time meets the 1/2 way of the additional 30 minutes (meaning 15 minutes or 75 minutes total) then the time meets 99291 + 99292

    If CC guidelines were not met, code an E&M for the eval since your group did not admit

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