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-- [ From: Martin Herman * EMC.Ver #2.10P ] --
 
This issue has been addressed in the past but under a slightly
different rubric.
By "bill" are you referring to the hospitals ability to advertise
itself to the public as having pediatric services? or are you referring
to the ability to submit a claim to some health care provider for
pediatric service.
 
Actually the issue is really moot to me because,  if the ED physician
sees children at all, then that is a pediatric service though a
difference might be noted in caring for the very small number of
children that really fall into the pediatricians areas of expertise. (
an ex premie or difficult pediatric - inborn error etc). Yet, if the
emergency physician recognizes the extent of their abilities and
referrs appropriately, then the public's welfare is served. Frankly for
the majority of children that present for emergency care, any competent
physician could do the job. I think the same could be said for the
majority of adult that present to the emergency departments of most
hospitals. SO, if the emrgency department follows the basic rules of
triage, treating what it can, and referring out the cases it is unable
to handle, once again the public is well served.
 
No there is no differences in the fee billable or percent collected for
any particular CPT code germane to emergency medicine, irrespective of
the type of physician that bills for the service. I know there are some
codes that only certain physicians can bill for, but by and large most
emergency services fall out of the particular exceptions.
 
I hope the public would want and appreciate those hospitals that offer
pediatric emergency medicine trained physicians, who stand ready to
minister to the special needs of children.  They ( the public) also
must realize that there are too few (PEM MD's)to cover every emergency
department in the countryand more importantly that every child does not
require that level of expertise.
 
I look forward to any feedback,
 
 
Regards,  MIH
Memphis
 
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The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html