ED Coding and Reimbursement Alert

Question: I’ve heard that ED physicians cannot charge for both an ED E/M and observation services on the same date of service. Is this correct?

Codify Subscriber

Answer: Yes, you’re correct. CPT^® specifically states that you shouldn’t separately bill any other evaluation and management services that the physician provides on the same date in sites related to initiating observation status.

The observation-care level of service should include the services related to initiating observation status that the doctor provided in other sites of service (as well as services in the observation setting, when the same physician provides them). If one physician provides an emergency department service and a second physician of a different specialty or group admits to observation, both can receive separate payment.