Wiki Emergency Room Charge / Surgery same day

[sandymary]

CPT code 99284 was billed by the emergency room physician.

CPT code 44970 was billed by the surgeon on the same date of service. This claim was paid.

The emergency room physicians claim was denied by the payer as included in the surgery.

Is this correct?

 

[FTessaBartels]

Two different specialties

Even if they are in the same practice, if they are of two different specialties then they should each be able to bill for their services and each get paid.

Appeal with notes and a letter of explanation.

F Tessa Bartels, CPC, CEMC