LTibbetts
Guest
We have an issue that keeps coming up where I work and I was wondering if anyone can give me any information or point me to something (from CMS) in writing for this concern: (keeping in mind that we are a rural CAH and we code for both pro and facility in the ER)
We have a patient that comes into the ER, s/he is seen in one of the clinics on the same day. For medicare, the accounts have to be combined, correct?, which means that both E&M are now on the same account?
If that is the case, how can you bill for both E&M's for that day, or can you? Do you have to take one of the E&M levels off of the account?
I realize that there can be many different scenerio's so would the outcome different if the patient was seen for different reasons (different diagnosies)? What if it's the same dx?
What if the patient was sent from the ER directly from the office and the patient sees whoever is on-call at the hospital (never the clinic physician)? In our system here, the patient would never be seen by the same provider if they had an ER and an office visit the same day.
We have a patient that comes into the ER, s/he is seen in one of the clinics on the same day. For medicare, the accounts have to be combined, correct?, which means that both E&M are now on the same account?
If that is the case, how can you bill for both E&M's for that day, or can you? Do you have to take one of the E&M levels off of the account?
I realize that there can be many different scenerio's so would the outcome different if the patient was seen for different reasons (different diagnosies)? What if it's the same dx?
What if the patient was sent from the ER directly from the office and the patient sees whoever is on-call at the hospital (never the clinic physician)? In our system here, the patient would never be seen by the same provider if they had an ER and an office visit the same day.