tci ED Coding & Reimbursement Alert - 2001 Issue 6

Reader Question: E/M Bundled With Observation Status

Question: In the past we have collected payment for both the echocardiograph (EKG) observation code and ED E/M level of service. Our understanding has been that the physician performed (and documented) additional work to admit the patient to EKG observation status, and therefore the ED visit and the observation status were separate. Are we correct?Stacey LevittCaduceus Inc., ChicagoAnswer: No. Generally, the rule for physician billing is one E/M per calendar date. The ED visit (99281-99285) payment is included in the admission to observation (99234-99236, observation care levels 1-3; 99218-99220, initial observation care levels 1-3). Codes 99217-99220 are used...

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