COBRA and EMTALA clearly mandate that all patients seeking emergency care at
a facility [note...not necessarily the ED] must receive a screening exam.
That exam must include all ancillary support needed to determine whether or
not an emergency condition exist. It does not mandate that once it has been
decided that an emergency condition doesn't exist, that there is a
requirement to treat. Not treating does however present a risk issue, so it
is advisable to treat.
A facility may designate who does the medical screening exam. However the
intent of the regs do not consider triage a medical screening. To bill for
the exam, one must meet necessary requirements to be considered an acceptable
provider by payors. Note that when APCs come into effect, there is not APC
for a Medcal Screening Exam, one would charge the E&M code for the
appropriate ED visit level [most likely level 1].
Hope that is hel[ful.
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