Wiki E/M with endoscopy in the ED, same day

Create Wiki
K

Kerly F

New
Messages
9
Location
Orlando, FL
Best answers
0
I have a patient who was seen in the ED but Never admitted.
Evaluated by ER MD, and then seen by my GI MD.
My GI MD did an E/M and immediately did an EGD, since pt had a 'foreign body in the esophagus', pt was stable, he was able to talk and breath but since this 13 yr old knew he had 'accidentally swallowed' a piece of a pen..... and was not able to regurgitate it back...
sent to ER.
Now can I code the E/M AND the EGD both done in the ED with a modifier 25 or...
Has anyone heard of any guidelines saying otherwise?
Also which E/M range should I use if any??
Please Help:confused:
Thanks,
Kerly Fernandez, CPC
 
You can code an out-pt E/M service with the EGD, but it depends upon the carrier as to whether you'll get reimbursed. Some might pay if you append -25 to your E/M. Some will want mod -57. Some will deny the E/M outright. But you should appeal denials as no GI physician merely shows up in the ER and throws an endoscope in a pt without talking to them & examining them. IMHO, if the physician has a well-documented E/M, he or she should be reimbursed for their work.
 
You must log in or register to reply here.
Top