Wiki 99284/99285 on the same claim

Create Wiki
A

abbyb

New
Messages
3
Location
New Milford, CT
Best answers
0
My son went to an ER after falling and fracturing his wrist.
The ER is billing a 99284 under rev code 450 and a 99285 under rev code 981.
It is my understanding that you cannot bill these two codes together per CMS guidelines. Is that true?
And if so, what 99- code range would normally be billed with the ER visit?

Appreciate any guidance!
Thanks!
 
Why they aren't using the same code for both is beyond me. ER is 99281-99285. Level 5 seems high for a fall with a broken arm, I'd probably dispute that with the hospital but probably wont change the rate by much

A critical access hospital has the option to bill both the facility and professional charge on the same claim. Now if you get a bill from a physician then you have a problem. Rev 0450 is for the room itself Rev 0981 is rev code for professional ER charges
 
The rev code 450 is the facility bill for the use of the facility, the rev code 981 is the physician service. The facility uses the same E&M codes as the physician but uses different criteria. The levels of service do not need to match.
 
You must log in or register to reply here.
Top