Mulitple E/M for ER same visit.

[JERRYHOUCHIN]

Can anyone help me. I have a hospital that states that they can bill 2 E/M at the same encounter for same visit by same physician.
example:
99283 for hypertension
99284 for hypertension
Does anyone know where this would be in writing that you can not charge. Or is this a matter of just meeting the criteria for each charge??
Thanks, Jerry

 

[LLovett]

I am really curious on how you could possibly meet the criteria for 2 different levels of service for the same problem in the same visit. This sounds impossible to me.

How would you get the service paid and not get rejected as a duplicate? I will do some checking and see if I can find anything on this scenario but honestly this sounds shady to me at best.

Laura, CPC

 

[becka95]

Is there separate documentation for the E&M encounters? I copied the below section from the Highmark Medicare site in reference to E&M. I have had encounters where the patient was seen in the morning and returned in the afternoon for a different or worsening condition, this is acceptable to report to Medicare.

Highmark Medicare Services would not expect to see two E/M services reported on the same date on a routine basis. A second E/M service would be billed for rare circumstances only. If a second E/M service is required on the same date of service, the documentation should clearly provide evidence that the second E/M service occurred, the reason for the additional E/M service, and documentation of the medical necessity of the second E/M service. If a second E/M service is reported on the same date, the service could initially be denied.

The link for the E&M center through Medicare is:

http://www.highmarkmedicareservices.com/partb/em/index.html

Hope this helps!!