tci E/M Coding Alert - 2013 Issue 5

You Be the Coder: Don't Automatically Combine ER and Office Visits

Question: If a patient was seen for an office visit (99214) first and then later on the same day went to the hospital emergency room and was seen again by the same physician (99284), would both visits be payable by Medicare? Arizona Subscriber Answer: The answer depends on how the emergency room first visit came about. If the doctor says during the office visit that the patient should go to the ER, then you should combine the work of the two services and report just one code — the 99214 (Office or other outpatient visit for the evaluation and...

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