Wiki E&M and ER on same day

[StacyGalloway]

Need help with this billing issue. Pt comes into the office is billed an E & M amongst other things. Pt then is seen in the ER same day but at night for a fracture. Medicare does not want to pay for both E & M codes that were billed by the two different doctors, separate times, and different place of service. Any thoughts?

Thanks!

Stacy - CFPC

 

[sivagurulingam]

Need help with this billing issue. Pt comes into the office is billed an E & M amongst other things. Pt then is seen in the ER same day but at night for a fracture. Medicare does not want to pay for both E & M codes that were billed by the two different doctors, separate times, and different place of service. Any thoughts?

Thanks!

Stacy - CFPC

Hi,

We can re-appeal the claim, make sure if the reason for the encounter want to be different and service rendered by different speciality provider.