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Thread: Procedure same day as ER

  1. #1
    Join Date
    Apr 2007

    Default Procedure same day as ER

    AAPC: Back to School
    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 ?

    Last edited by cpccoder2008; 08-26-2009 at 12:58 PM. Reason: I wanted to post in ER but accidently post here.

  2. #2
    Join Date
    Apr 2007


    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
    Mary, CPC, CANPC, COSC

  3. #3
    Join Date
    Apr 2007


    According to several article's i have read you don't have to attach a -25 with ER and new patient visit's.
    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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