tci ED Coding & Reimbursement Alert - 2001 Issue 9

Reader Question: E/M Services

Question: Can we bill for E/M services in the ED if the patient is admitted? Because Medicare will pay for only one E/M service per day, if the ED physician bills one level E/M and the attending physician admitting the patient bills another E/M, how does the ED get paid?Montana Subscriber  Answer: The key to payment is specialty designation and the particular E/M codes selected. For the E/M coding, the ED physician will use the appropriate codes in the 99281-99285 series (emergency department services), while the admitting physician will use the 99221-99223 series (initial hospital care). Because...

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