Wiki Multi ED Visits on the Same Day

[JulieM]

I am looking for some documentation/help that states if a patient comes into the ED more then one time for the same diagnosis on the same day that you roll them into one visit. The hospital that I work for wants me to bill each visit separately. I have shown my supervisor who is not a coder CMS documentation but that was not good enough due to was not specific enough. Any help would be appreciated...

 

[20Hiker16]

Try reviewing the following document from Medicare:

http://www.medicarenhic.com/providers/pubs/Evaluation and Management Billing Guide.pdf

See page 11.

We apply the 24 hour rule to outpatient ED visits and bill for only one visit, as explained in the above document, when patient comes in for a second visit; for the same reason; on the same day. The ED physicians are employed by the facilily and are considered "group practice".

Hope this helps.