I am a professional services coder and work at an HMO in California. We use an EMR, but it's not fully functional-only a portion of the EMR was purchased. My Supervisor has inpatient credentials.
The patient has commercial payor insurance. I used -27 on the ER E/M because the patient was seen in the clinic earlier that day, documented in the ER progress note as well as viewing the medical record from the clinic to validate the clinic visit was performed, and the reason for both visits were not the same. Because my employer only allows the provider to code the office visit E/M, -27 was not coded on the office visit. My Supervisor recommends me to take -27 off the ER E/M because -27 should only be placed on the subsequent visit and she showed me the guidelines from CMS. I explained to her the guideline she just spoke of is for Medicare and read her the guidelines from the CPT book. Then she said because I didn't code the office visit along with the ER E/M I should take -27 off.
How would you proceed?
The patient has commercial payor insurance. I used -27 on the ER E/M because the patient was seen in the clinic earlier that day, documented in the ER progress note as well as viewing the medical record from the clinic to validate the clinic visit was performed, and the reason for both visits were not the same. Because my employer only allows the provider to code the office visit E/M, -27 was not coded on the office visit. My Supervisor recommends me to take -27 off the ER E/M because -27 should only be placed on the subsequent visit and she showed me the guidelines from CMS. I explained to her the guideline she just spoke of is for Medicare and read her the guidelines from the CPT book. Then she said because I didn't code the office visit along with the ER E/M I should take -27 off.
How would you proceed?