Wiki E/M same day

[codedog]

Will medicare pay for an E/M codes on the same day when the doctor does pain management codes.
ex---- Say the patient is schedule for an ESI -cpt code 62311-- doc sees the patient does an E/M on patient , then does the ESI-,is this ok to bill both codes . ?

 

[FTessaBartels]

Scheduled for procedure

If patient is scheduled for the procedure (injection, in this case), then no E/M is coded UNLESS there is a significant, separately identifiable service. The routine evaluation of the patient prior to the injection does NOT meet the definition of a "significant, separately identifiable E/M service."

For example, patient comes in for the injection and mentions that he has a rash on arm. Doctor's evaluation (and documentation) of rash would be a significant, separately identifiable E/M from the injection.

Hope that helps.

F Tessa Bartels, CPC, CEMC