tci ED Coding & Reimbursement Alert - 2019 Issue 7

Reader Question: Separate Observation From E/M

Question: I’ve heard that ED physicians cannot charge for both an ED E/M and observation services on the same date of service. Is this correct? Supercoder Subscriber Answer: Yes, you’re correct. CPT® specifically states that you shouldn’t separately bill any other evaluation and management services that the physician provides on the same date in sites related to initiating observation status. The observation-care level of service should include the services related to initiating observation status that the doctor provided in other sites of service (as well as services in the observation setting, when the same physician provides...

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