Wiki 2 E&M's same day

[carol ann]

I have submitted this question before and still we are having problems. Dr Smith is a Emergency Room doctor and employed by our hospital. Patient is seen in the ER by Dr Smith. Dr Smith calls the patients primary doctor who is Dr. Jones. Dr Jones wants the patient admitted to the hospital. Dr Smith admits her to Dr. Jones. 2 hours later Dr. jones comes to the hospital and sees the patient and writes his H&P.
Now the problem we are having is:
1 ER fee-99281-99285 for Dr Smith AND 1 H&P fee-99221-99224 for Dr Jones

Medicare denies one of the pro fees because they are on the same day.
So my question is how do we bill and get paid for both pro fees?

 

[mhstrauss]

Is the AI modifier being used on Dr. Jones's 9922X admit code?

 

[FTessaBartels]

Dr Smith's specialty

Also ... is Dr Smith listed with Medicare as an Emergency Medicine specialist? Or is he an Internal Medicine physician, just like the primary physician, and in the same practice?

Hope that helps.

F Tessa Bartels, CPC, CEMC