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E & M visit

Misty Posted Mon 20th of February, 2012 17:39:56 PM

A patient was initially evaluated in ER by ER physician. My obgyn physician was oncall and asked to evaluate and ended up transferring patient. Can I also bill E&M code in the ER?

SuperCoder Answered Mon 20th of February, 2012 21:29:32 PM

Hello – Here’s the Medicare rule:
“F. Emergency Department Physician Requests Another Physician to See the Patient in Emergency Department or Office/Outpatient Setting
If the emergency department physician requests that another physician evaluate a given patient, the other physician should bill an emergency department visit code. If the patient is admitted to the hospital by the second physician performing the evaluation, he or she should bill an initial hospital care code and not an emergency department visit code.” (30.6.11 - Emergency Department Visits, https://www.cms.gov/manuals/downloads/clm104c12.pdf)

Regards,
Deborah Marsh, JD, MA, CPC, CHONC
The Coding Institute

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