# Question



## Tamara Clarke (Nov 3, 2010)

Question?

1/ If a patient comes in the ER goes hom/discharge and comes back with in 24hours is a new account suppose to be opened?

2/ If the first physician charges the patient who worked on the morning shift, then another physician comes on the evening shift when the patient returns to the ER, can both physicians charge the patient or is there a code to use so both physicians can be paid?


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## mitchellde (Nov 3, 2010)

are you coding for the facility or the physician?  It makes a difference.


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## eadun2000 (Nov 3, 2010)

Tamara Clarke said:


> Question?
> 
> 1/ If a patient comes in the ER goes hom/discharge and comes back with in 24hours is a new account suppose to be opened?
> 
> 2/ If the first physician charges the patient who worked on the morning shift, then another physician comes on the evening shift when the patient returns to the ER, can both physicians charge the patient or is there a code to use so both physicians can be paid?



For physician coding, you would combine the visits for ONE E&M.  For Facility, I believe you add modifier 27 to the second E&M.  I don't have my book in front of me, but I think that is the modifier.


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## katrinabgood (Jan 6, 2011)

That is correct, eadun2000, Modifier 27 is added to the second ED visit within 24 hours.


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## alices (Jan 15, 2011)

*2 er visits*

Is that documented in writing somewhere and if so where , that if the pt comes in x2 on same day sees 2 different physcians, that it is combined (for physcian side)?, is that just for mcare pts or all insurances, and that applies to same physcian as well? I work for a hospital and code both sides, the billing for the physcian side is done by an outside co, and as stupid as this sounds I did not know this rule/guideline..Thank you for all the help..alice


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