tci ED Coding & Reimbursement Alert - 2006 Issue 3

READER QUESTIONS: Investigate POS for 99291

Question: A patient presented to the ED as critical care, and the physician subsequently admitted him to inpatient status. Later, the patient coded on the floor. The ED physician who saw him in the ED responded to the code blue on the floor. Medicare is denying our claim for the code-blue service, saying we are allowed to bill for only one E/M service per day. Is this because the same physician saw the patient? How should we report this?Georgia Subscriber Answer: You can only report 99291 (Critical care, evaluation and management of the critically ill or critically injured...

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