Awareness : Did You Know? 2015-2016

Did You Know? Weekly Educational Series 38

For the Week of June 20, 2016

Emergency Department Visits (codes 99281-99288)

Physician billing for emergency department services provided to patient by both the patient’s personal physician and emergency department (ED) physician. If the ED physician, based on the advice of the patient’s personal physician who came to the emergency department to see the patient, sends the patient home, then the ED physician should bill the appropriate level of emergency department service. The patient’s personal physician should also bill the level of emergency department code that describes the service he or she provided in the emergency department. If the patient’s personal physician does not come to the hospital to see the patient, but only advises the ED physician by telephone, then the patient’s personal physician may not bill.

If the ED 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 (99221 – 99223) and not an emergency department visit code.