Emergency Department Referrals
The transfer of care or portion of care is a referral.
• The Emergency
Department provider requests that the specialist take over care or a portion of
care. The Emergency Department does not
intend for the patient to receive follow-up care in the Emergency
Department.
• To code Emergency
Department services with separate specialist services, there will be two ADM
records created.
• An appointment
will be generated in the Emergency Department.
The Emergency Department provider will document services he
provided. In the documented plan of
care, the Emergency Department provider will indicate a portion or all of the
care will be transferred to the specialist.
The Emergency Department provider will generally use a code in the
99281-99285 series and collect the care in the BIAA MEPRS.
• The specialist
will document his services in a separate document. The specialist will have an appointment
generated in his clinic, usually a “walk-in.”
The appointment will be marked as “kept” which will generate a report to
be completed in the ADM. This will be a separate
ADM report than the report generated in the Emergency Department. The specialist will usually code an office
visit range of 99201-99215 in the specialist’s outpatient clinic MEPRS.
• If the specialist
admits the patient, there would not be a clinic appointment generated, but the
documentation would become part of the inpatient record and collected in the
IBWA rounds appointment.
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