CC coding w/ an E&M.

Prissyz1

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I have reviewed the webinar on the CC service. I still have unanswered questions, and hope you can help. The webinar stated that a provider who truly does CC (my provider does cc) for a patient, can also bill an E&M if medically necessary on the same date. I understand that my provider would need to document the CC time, and also document the E&M service in the ED. What has me a little confused is the webinar stated the E&M could not be billed (time wise) after the CC on same date. Please help me understand how the CC works. If my provider is treating a patient for 37 min for CC, then the patient becomes stable. Next my provider makes 2-3 rounds in the hospital on the same date to check on the patient. Is "checking on the patient" included w/ the CC time? Or, would that be an E&M?

I hope this makes sense. I greatly appreciate your expertise on this topic. TIA
 
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I have reviewed the webinar on the CC service. I still have unanswered questions, and hope you can help. The webinar stated that a provider who truly does CC (my provider does cc) for a patient, can also bill an E&M if medically necessary on the same date. I understand that my provider would need to document the CC time, and also document the E&M service in the ED. What has me a little confused is the webinar stated the E&M could not be billed (time wise) after the CC on same date. Please help me understand how the CC works. If my provider is treating a patient for 37 min for CC, then the patient becomes stable. Next my provider makes 2-3 rounds in the hospital on the same date to check on the patient. Is "checking on the patient" included w/ the CC time? Or, would that be an E&M?

I hope this makes sense. I greatly appreciate your expertise on this topic. TIA

In order to bill both an E/M charge (inpatient hosp or office/outpatient) and a CC charge on the same date for the same provider, the E/M service has to occur at some point BEFORE the CC service. ED services are an exception; they are not payable when CC services are provided to a patient on the same date by the same provider.

In one of your examples, the provider sees the patient in the ED and also provides CC. In this situation, the ED services can't also be billed under any circumstance (if you're billing an ED code).
In your other example, the provider does 37 mins of CC, then sees the patient, who is no longer critically ill, later in the day during rounds. In this situation, you can bill for CC time, but not for the E/M services provided afterward.

Using that example again, the provider does 37 mins of CC, the patient remains critically ill and the provider sees the patient later in the day for an additional 30 mins of CC, the patient then becomes stable and the provider sees the non-critically ill patient for a third time on that date. In this case, you would total the CC time to 67 mins and bill accordingly. The third visit would not be billed because it's an E/M service (not CC) and is occurring after the provider saw the patient for CC earlier in the day.

In other words, if the E/M service happens BEFORE the CC service, both are payable. If the E/M service happens AFTER the CC service, only the CC service is payable.
 
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