The Er physician should combine the documentations of the 2 encounters and bill one visit. In the case of the injury as the second visit this may depend on the liability and therefore quite possible to submit 2 visits to 2 different carriers. The facility will submit 2 ED visit levels on the same day in the same revenue center and will apply a 27 modifier to the second and subsequent visit level. If a procedure is performed at either of the encounters then both visits will need a 25 modifier in addition to the 27 on the second and the claim will need a G0 condition code.
Facility billing is very different from physician!
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