Results 1 to 6 of 6

Physican ordered infusion in ED

  1. Unhappy Physican ordered infusion in ED
    Exam Training Packages
    I work for a CAH hospital in rural PA & we are having a debate regarding outpatient non-emergency services provided in the ER. Basically, a patient was seen in their physician's office and given an order for IV drug administration & the infusion was to take 4-5 hours. We do not have an infusion clinic in our hospital and the short procedure unit was too full to take the patient. Therefore, the patient was given the infusion in the ER & there is a debate as to whether or not an ER facility fee can be charged. I say no, as does another coder in my office. The patient was not seen by the ER physician; they had an outpatient order in hand & presented for an outpatient service NOT an ER service. Anyone else come across this scenario?


  2. Default
    Yes you should charge on the facility side. The physician does not need to see the patient in order to charge for the facility. The patient is taking up time and resources of the ER and should definitely be billed on the facility side.

  3. Default
    Maybe I didn't make myself clear. I agree we should charge for the infusion service, but I don't feel they should be charged a "facility" ER visit - the facility side of the E/M. The patient did not present as an ER patient - our facility placed them in the ER for this outpatient service. If they had the infusion on the short procedure unit, they would be charged for the infusion only. I feel charging them for the facility ER visit in this case is wrong. The ER nurse is not triaging the patient, she is simply carrying out the order that was written based upon a previously provided E/M in the physician's office.

  4. #4
    I would have to agree with you, Victoria. I wouldn't feel comfortable charging an ER facility charge when the ER is just being used for "overflow" location.

    If the nurse is using the same items to run the infusion as would be used in your other location, and no further work or treatment is being done to the patient, the only charge would be the outpatient charge.

    We also run IVs in a room just off our ER with our ER nurses starting, watching, documenting, etc., and we don't charge an ER charge, just the infusion charge.

  5. #5
    Columbia, MO
    The facility has the same requirement for a 25 modifier as the physician, so... If the patient was scheduled or it was known that the patient was comming in for IV infusions then there would be no visit level regardless of place of service.

    Debra A. Mitchell, MSPH, CPC-H

  6. Default
    Thank you both for your input!!! It is greatly appreciated.

Similar Threads

  1. Tests ordered following treatment
    By Scatlot in forum Diagnosis Coding
    Replies: 0
    Last Post: 01-09-2014, 03:01 PM
  2. testing - ordered by one Dr, interpreted by another
    By tgutierrez in forum Ophthalmology/Optometry
    Replies: 1
    Last Post: 10-24-2012, 09:53 AM
  3. Mri ordered
    By grandmacora in forum E/M
    Replies: 1
    Last Post: 09-06-2012, 03:49 AM
  4. EKG Ordered
    By rbeaver in forum E/M
    Replies: 2
    Last Post: 12-13-2011, 03:39 PM
  5. LP ordered
    By selsal in forum E/M
    Replies: 1
    Last Post: 06-08-2011, 11:24 AM

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.