tci Medicare Compliance & Reimbursement - 2021 Issue Q2

Reader Question: Gauge Whether Visits Were Related

Question: We had a patient come into our emergency department (ED) then leave after seeing the physician. She came back a few hours later for a second ED visit that was connected to the original complaint. How do we code for two visits on the same day that are related? Texas Subscriber Answer: Although it’s tempting to report two different codes for the separate ED services, that’s not always the best approach. Some payers will not reimburse you for two related E/M visits on the same date of service. Your first step when making the determination of...

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