Radiology Coding Alert

Clear up your E/M-definition confusion with this FAQ

E/M coding has become increasingly important for interventional radiologists. Are you up to the task?

Check yourself against the experts with this common E/M question.

Define Day by Calendar Date, Not Hours

Question: A patient visits the physician for a previously scheduled E/M visit at 5:00 p.m. on Tuesday. The physician bills 99213 for that date. On Wednesday at 10:00 a.m., the patient returns to the same physician complaining of a new problem. The physician evaluates the problem and bills 99213.

I know that I can report only one E/M "per day." Because both services fell within the same 24-hour period, should we combine the Wednesday visit with the Tuesday E/M service and bill just one code?

Answer: CPT's descriptions refer to E/M services "per day," not per 24-hour period, so you can report separate codes for your physician's services, says Stephen Levinson, MD, author of the AMA's Practical E/M: Documentation and Coding Solutions for Quality Patient Care.

"The day starts at midnight and ends at 11:59:59 p.m.," Levinson says. "We all know that we are only allowed one inpatient E/M per day. Of course, we also know that if you admit a patient at 10:00 p.m. and submit a 99222 hospital admission code, it is completely appropriate to see the same patient at 7:30 a.m. the next 'day' and submit a 99232 for subsequent hospital care."

The same coding principles apply to outpatient services. You're allowed to bill separate services on different calendar dates, assuming that the physician's documentation meets CPT criteria to report the E/M visits on both dates.