We have two hospitals in our area, ours and another. Our hospital has a pediatric cardiologist whereas the other one does not. When premie patients are born at the other hospital and thought to have a cardiac problem they are tranferred here via ambulance for our cardiologist to evaluate them since he does not have a contract with the other hospital. Even though they are inpatient at the other hospital we do our billing as outpatient for physician's and facility. I bill for the physician's and questioned this scenario since i thought it should be inpatient and our facility compliance department explained to me that it would be just as if a patient were sent somewhere's for an outpatient MRI. I am not sure how the facility was affected by this but our E/M charges were paid and never denied. Hope this helps.
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