mwells2020
Networker
- Messages
- 95
- Best answers
- 0
I am just needing to know if I can bill for prolonged services with an ER E&M for a Medicaid patient that also has an office visit on the same date of service? Thank You in advance for your time!
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Billing prolonged services
- Thread starter mwells2020
- Start date
SharonCollachi
Guest
No.
Can you elaborate? Is it due to place of service? If patient is originally seen in office, then sent to ER, coded as outpatient code and the ER time was longer than the time allotted for a 99205/99215, what is the reason you would not be able to use prolonged services? Thank you.
SharonCollachi
Guest
Are you trying to bill for both an office visit and an ER visit on the same day? ER codes are not time-based therefore there is no extended time for ER.
Sharon, I'm sorry, oops, not ER. I'm referring to observation consult codes (General Surgery here) which I would bill as an outpatient new/est patient as long as the patient was not going to be admitted and as we are not the attending. I'm awful at this part of coding, so just looking for some help. Thanks!
SharonCollachi
Guest
I'll defer to someone else then. We do not see anyone in observation status, and I don't want to misguide you.
TThivierge
True Blue
Hi
I d use or append modifier 27 when reporting multiple outpatient hospital evaluation and management (E/M) services on the same date. Modifier 27 was created exclusively for hospital outpatient departments (ex. hospital emergency department, clinic, and critical care). Also for the CPT prolonged services hope provider added how many minutes documented in medical documentation for that day.
I hope this data helps you
Lady T
I d use or append modifier 27 when reporting multiple outpatient hospital evaluation and management (E/M) services on the same date. Modifier 27 was created exclusively for hospital outpatient departments (ex. hospital emergency department, clinic, and critical care). Also for the CPT prolonged services hope provider added how many minutes documented in medical documentation for that day.
I hope this data helps you
Lady T
JennyMarie19
New
@TThivierge Do you have any resources concerning Mod-27? My supervisor is asking me to research it's usability in the ED. I know the Modifier descriptor uses "emergency department E/M code(s)" as an example, but that's likely not enough for the discussion. Any information you could provide would be greatly appreciated!Hi
I d use or append modifier 27 when reporting multiple outpatient hospital evaluation and management (E/M) services on the same date. Modifier 27 was created exclusively for hospital outpatient departments (ex. hospital emergency department, clinic, and critical care). Also for the CPT prolonged services hope provider added how many minutes documented in medical documentation for that day.
I hope this data helps you
Lady T
TThivierge
True Blue
Hi Jennifer
Yes modifier 27 can be linked with any outpatient CPT code related to service in differ departments in the same hospital or clinic. The catch is must be different doctors or medical specialties or outpatient locations treated on same date.. Check in the CPT manual in Appendix A listing differ modifiers. Also you can list up to 4 modifier on each claim line. Did you know if have same lab tests done on same date you can use modifier 91 on second set of lab test? I know sometimes if a patient is in EMR for a long period will run lab test again. In the medical coding textbook 321 Code It Chapter 8 focuses on uses of different modifiers.
Well I hope helped you and your department
Lady T
Yes modifier 27 can be linked with any outpatient CPT code related to service in differ departments in the same hospital or clinic. The catch is must be different doctors or medical specialties or outpatient locations treated on same date.. Check in the CPT manual in Appendix A listing differ modifiers. Also you can list up to 4 modifier on each claim line. Did you know if have same lab tests done on same date you can use modifier 91 on second set of lab test? I know sometimes if a patient is in EMR for a long period will run lab test again. In the medical coding textbook 321 Code It Chapter 8 focuses on uses of different modifiers.
Well I hope helped you and your department
Lady T