Linda Hillman
New Member
The patient comes to the ER with a dislocation of the RT hip. The ER MD performs the assessment (99284) as well as the relocation of the RT Hip (27265). For the facility side Hospital Billing would you have both the E&M 99284 -25 and the procedure 27265. And then a Pro-Fee for procedure CPT and the E&M for the ER MD .
The ER Coder, that I work with is telling me that when an ER MD performs the procedure, only the E&M is coded not the procedure CPT on the HB side and the procedure CPT is only coded on the Pro Side.
But when an outside Ortho MD is called in performs the Procedure in the ED the coder captures the procedure CPT for the HB side and the MD Pro Biller capture the Pro Fee.
My reply is that the procedure CPT should be capture regardless if its the ER MD or an outside Ortho MD that is called in on the HB side, the difference would only be on the professional side. Is this correct?
The ER Coder, that I work with is telling me that when an ER MD performs the procedure, only the E&M is coded not the procedure CPT on the HB side and the procedure CPT is only coded on the Pro Side.
But when an outside Ortho MD is called in performs the Procedure in the ED the coder captures the procedure CPT for the HB side and the MD Pro Biller capture the Pro Fee.
My reply is that the procedure CPT should be capture regardless if its the ER MD or an outside Ortho MD that is called in on the HB side, the difference would only be on the professional side. Is this correct?