星空入口

Reader Question: Bill Nonemergent ED Services as Outpatient

Question: A patient visited the emergency department (ED) complaining of cellulitis. Three days later, she returned for antibiotic therapy. How should I code these visits? Is it appropriate for her to return to the ED for this kind of treatment?
  
Maine Subscriber

Answer: You should report the initial encounter as an ED evaluation and management (E/M) visit with a code from the series 99281-99285 (Emergency department services), revenue code 45X (Emergency room), and type of bill (TOB) code 13X (Hospital outpatient).  

The subsequent visit for antibiotic therapy, if the physician schedules it, should count as an outpatient visit -- billed with TOB 13X -- but you should only report the infusion service.

If the patient arrives unscheduled or unannounced, the hospital staff must at least perform a medical screening exam, which you should report in addition to the antibiotic infusion service.