Wiki Can 2 providers code an ED E/M code on same day?

[Kera Weaver]

I am needing clarification on something I hope you can help!

CPT Assistant 2002, July states
For any single ED patient visit, only one physician can report an ED E/M code.

However...

CMS Pub 100-4, 12, 30.6.11
(E) indicates that 2 providers (the patients personal physician, and the ED physician) can bill an ED visit if patient is seen in the ED by both providers.
(F) indicates that 2 providers (the ED provider, and another physician) can bill an ED visit if patient is seen in the ED by both providers.

While this seems pretty clear and concise, my question is this?Does CPT Assistant 2002, July still stand or does this CMS Revision 1875 over ride CPT assistant from 2002?

For example, if a patient goes to the ED and the ED provider does his evaluation and calls in an Ortho provider and he also evaluates the patient, do both get an ED E/M?

Sincerely,

 

[missy874]

Yes both would bill an ED unless the Ortho admits the patient or places the patient into observation, otherwise that is the code. We do it all the time with our psych patients. Sometimes notes are requested, but in general they stand up as services in the ED

 

[Kera Weaver]

Hi Missy, Thank you for your response.

I am looking at an article from "American College of Surgeons" I need to make sure I have my head around this correctly. This article states if the patient is not a medicare patient, then we should use the consult codes.

http://bulletin.facs.org/2013/02/coding-for-hospital-admission/

So if this be the case, then it just depends on if the patient is a medicare patient or not. Correct???

 

[nomerz]

It mostly depends on the scenario, but yes, you can bill two E&M's on the same day. Say a patient is seen in the morning for a headache and is seen that same day in the afternoon for an ankle fracture. Both visits would be billable. If the patient is seen twice in the same day for the same thing (maybe they're experiencing an increase in symptoms) you would typically combine the visits into one charge.