tci ED Coding & Reimbursement Alert - 2014 Issue 4

Facility Coding: How to Bill for Dx Studies When ED Patient Doesn't See the Doc

Read the rules carefully to determine which services are reportable and which are not without physician involvement. It happens in most emergency departments: A patient comes in, is triaged and receives diagnostic testing such as a chest x-ray or an EKG, depending on their presenting symptoms, but leaves without ever having been seen by a physician. In such circumstances, can a hospital bill for the diagnostic test?  The short answer: You can’t report a professional Evaluation and Management ( E/M) service, or a facility visit level service that would require an ED physician seeing the patient, but...

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