tci ED Coding & Reimbursement Alert - 2005 Issue 10

Reader Questions: Separate E/M and Observation

Question: I've heard that ED physicians cannot charge for both an ED E/M and observation services on the same date of service. Is this correct?California Subscriber Answer: Yes, you're correct. CPT specifically states that you shouldn't report separately any other evaluation and management services that the physician provides on the same date in sites related to initiating observation status. The observation-care level of service should include the services related to initiating observation status that the doctor provided in other sites of service (as well as services in the observation setting, when the same physician provides them). If one...

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