tci E/M Coding Alert - 2013 Issue 8

Reader Question: AMA Advises 59, Not 25 for Same-Day E/M

Question: Can you advise regarding a successful way to get Medicare to pay for two emergency department (ED) visits on the same day for different diagnoses? I am unsure if modifier 77 would work at this point. New Hampshire Subscriber Answer: 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 E/M 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...

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