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Thread: Mulitple E/M for ER same visit.

  1. #1

    Default Mulitple E/M for ER same visit.

    AAPC: Back to School
    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.
    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

  2. #2
    Join Date
    Apr 2007


    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

  3. #3
    Join Date
    Apr 2007
    East Stroudsburg, PA


    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:


    Hope this helps!!
    ~Rebecca, CPC, COSC, CPC-I

    "To the world you may be one person, but to one person you may be the world" ~Anonymous

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