Wiki Multiple E/M services on same day

[svatek.laura@gmail.com]

Coding for Emergency Department physicians....

When a patient comes in two or more times in one day, what modifier can be placed on the E/M code to ensure reimbursement?

I hear not to use -25 but that -59 is not to be used on E/M codes...

Any advice on what modifier to use in these situations? For both situations of same physician or different physician?

 

[Lynda Wetter]

In viewing the rationale fora question in the CEMC practice exam I have I came across this this morning...

"For all evaluation and management (E/M) encounters, except where specifically noted, carriers may not pay for multiple E/M office visits billed by a physician (or a physician from the same group practice) for the same beneficiary on the same day. All documentation for E/M services for the day are combined to determine one E/M code for the date of service."