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Procedure same day as ER

cpccoder2008

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Trying to get feedback on how everyone is coding these. We have heard several places saying they bill these services differently and just courious how eveyone is coding these.

When a patient has a procedure and an ER visit on the same day how are you coding this ?
Are you coding both and attaching a -25 ? If so, why ?
Are you coding both without a -25 ? If so, are they getting paid ?
Are you coding just the procedure ?

Also who are you billing for ?

Thanks
 
Last edited:

mbort

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When a patient has a procedure and an ER visit on the same day how are you coding this ?

I would use the appropriate e/m code with the appropriate 25/57 modifiers depending on the procedure that was performed

Are you coding both and attaching a -25 ? If so, why ?

not necessarily the 25, could be a 57--why??? because the e/m is separately reportable with a procedure appropriate documentation.

this coding would be done for Ortho Surgeons
 

cpccoder2008

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According to several article's i have read you don't have to attach a -25 with ER and new patient visit's.
http://www.medicarenhic.com/providers/pubs/Modifier%20Guide.pdf
page 24.

o This modifier should not be submitted with E/M codes that are explicitly for new
patients only: 92002, 92004, 99201-99205, 99281-99285, 99321-99323, and 99341-
99345. These services are not considered part of the global surgical policy.
 
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