Two ER visits in Same 24hr

vdelucci

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If a patient comes to the ER twice in the same day, with the same problem.
Do you combine the visits? What if they are different problems but still two visits on the same day? Does anyone have a reference?
 

RebeccaWoodward*

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Typically, you combine; however....

" Office/Outpatient E/M Visits Provided on Same Day for Unrelated Problems
As for all other E/M services except where specifically noted, carriers may not pay two E/M office visits billed by a physician (or physician of the same specialty from the same group practice) for the same beneficiary on the same day unless the physician documents that the visits were for unrelated problems in the office or outpatient setting which could not be provided during the same encounter (e.g., office visit for blood pressure medication evaluation, followed five hours later by a visit for evaluation of leg pain following an accident)."

http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf
 
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