Wiki Multiple E/M visits on same day

[svatek.laura@gmail.com]

Coding for Emergency Department physicians....

When a patient comes in two or more times in one day, what modifier can be placed on the E/M code to ensure reimbursement?

I hear not to use -25 but that -59 is not to be used on E/M codes...

Any advice on what modifier to use in these situations? For both situations of same physician or different physician?

 

[Lynda Wetter]

I might be wrong ( dont work with this to much) but, i thought you were supose to code 1 E/M per doc per date of service. So if patient came in 2xs you would combine the visit for that 1 doc and bill 1 E/M code?

 

[Lynda Wetter]

Coding for Emergency Department physicians....

When a patient comes in two or more times in one day, what modifier can be placed on the E/M code to ensure reimbursement?

I hear not to use -25 but that -59 is not to be used on E/M codes...

Any advice on what modifier to use in these situations? For both situations of same physician or different physician?

In viewing the rationale fora question in the CEMC practice exam I have I came across this this morning...

"For all evaluation and management (E/M) encounters, except where specifically noted, carriers may not pay for multiple E/M office visits billed by a physician (or a physician from the same group practice) for the same beneficiary on the same day. All documentation for E/M services for the day are combined to determine one E/M code for the date of service."

 

[ppt]

Best solution is to attached both ER MD notes and stated on your letter that patient was seen twice on the same DOS. I believe, if document shows that 1 ER MD discharges pt, then patient re-admit to ER.