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Thread: E & M Coding In Hopsital Setting

  1. #1

    Default E & M Coding In Hopsital Setting

    AAPC: Back to School
    I need some guidelines on coding for a General Surgeons office that have Trauma and Critical Care doctors that see the patient and then call in one of the surgeons to do surgery, all of the same practice each doing different care. Can someone direct me to some guidelines to follow?

    Thanks and Everyone have a great and Blessed New Year.

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Hope this helps

    I am NOT trying to be flippant, but basically each physician should document what s/he does, and the coder should then code what was documented.

    Without seeing actual notes, that's about all the guidance I can give you.

    If they are in the same practice and with the same specialty they are considered the same physcian. So if Dr A sees the patient in the ER and documents 30 minutes (or more) of critical care, sending the patient to the OR for Dr B to operate, then you'll have to be sure to add the -57 modifier on the 99291 E/M service.

    If they are of different specialties, or of different practices, then just code each one as per his/her documentation.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3

    Default Thanks

    Thanks for your suggestions, I was told by a insurance representative that it is whatever the doctors is contracted under is the way to bill it no matter if the doctor is of the same practice as the other ones. If one is Trauma Critical Care and the the other a surgeon you can bill for all procedures as long as they did not help one another.

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