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Thread: Patient Evaluated then sent to ER

  1. #1

    Question Patient Evaluated then sent to ER

    AAPC: Back to School
    What is correct?

    On occasion, my physicians will evaluate a patient in office, they perform elements of history and exam, and the MDM is that the patient be sent to ER or to the hospital for admission by a Hospitalist-not part of our group. I beleive this is a billable E&M as the physician is providing a complete service, they just happen to be deciding that care needs to be provided in a hospital setting. However, my physicians typically don't charge out a level on these visits and our nursing staff have even requested the patient be removed from the schedule--But a complete note exists. So, what is correct?

    Our facility is owned by a hospital, but my family practice physicians are still providing a service separate from the ER or admitting hospitalists.

    Hmmm....Would love to hear from someone.

  2. #2
    Join Date
    Apr 2007

    Default This seems to be a common misconception in offices

    That is most certainly a billable service. The only time it is not is when your doctor or another of their specialty in their group, goes to the hospital and does the admit. Then everything is rolled into the admit charge.

    Laura, CPC, CPMA, CEMC

  3. #3


    Thanks for the reply. Sometimes, I just need confirmation to feel secure in what I'm doing and in speaking with the physicians. I'm in a small rural area, so the forum has become a lifesaver for me! I so appreciate the assistance.

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