tci ED Coding & Reimbursement Alert - 2012 Issue 12

Reader Question: Two Visits, Same Day -- Too Confusing!

Question: Does anyone know a successful way to get Medicare to pay for two ED visits on the same day for different diagnoses? I am unsure if modifier 77 would work at this point. Has anyone been successful recently? Virginia SubscriberAnswer: Historically, it was thought that multiple office visits or Emergency Department visits in a single day should be combined and one single E/M should be billed under all circumstances. For multiple ED visits in a single day, CPT® Information Services has offered some guidance:"From a CPT® coding perspective, if a physician performs an E/M service for a patient...

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