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Thread: intubation

  1. #1

    Default intubation

    AAPC: Back to School
    I hope someone can answer this question, I code for both facility and profee, I have a chart dr a saw the pt and the pt was admitted on 1/15 later on that same day pt is in ICU and dr b from the ED is asked to go up in ICU and intubate pt, all dr b did was supervise the resident so how would I code this for the ER? she can only get the 31500 right? there wouldn't be an E/M? I have not had anything like this for a long time so any and all help would truly be appreciated..alice

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default ER doc intubates inpatient

    I'm a little confused with your scenario. Let me see if I have this straight ...

    ER doc called to the floor to intubate a patient who was previously admitted ....
    You will bill for the intubation - and place of service will be INPATIENT - 21

    Don't forget to put a -25 modifier on your E/M for the ER services you performed earlier in the day (significant, separately reportable E/M service on same day as procedure).

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3

    Default re-intubation

    yes I am sorry I too was confused, the er dr that went up to ICU was not the same Dr that saw the pt earlier in the day, what is confusing me I don't know/understand how my ER Dr is going to get paid for the intubation. I work for the hosp doing both facility and profee, but the ER drs have a billing svc that bill out their charges so I am not sure how to handle this, should I just write out a charge for the intubation and send to the billing svc or will this go on the inpt side..I really have never come across this in the 5years working here at this hosp, maybe one of the other coders have but not me..so really sorry if I am still confusing any one..thanks for all the help, alice

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default Unique protocol

    Your question seems to be more about the unique protocol of your institution, and I really cannot answer that question.

    Here's what I CAN answer.

    Are both ER docs in the same practice and with the same specialty?
    If YES .. then for insurance purposes they are considered the same doctor. The one who saw the patient in the ED earlier in the day will need a -25 modifier on his E/M service (yes, ED charges are an E/M service) to show that it is a significant, separately reported service from the intubation.

    As for WHO is going to submit the charge for the intubation ... I don't know what your company practice is. I suggest that you contact the inpatient coders and verify that they will be picking it up. If they are NOT going to pick it up, then you will have to submit the charge.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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