tci ED Coding & Reimbursement Alert - 2002 Issue 8

Seeing Double in the ED: Assigning Multiple E/M Codes on the Same Day

The rule of thumb for assigning E/M codes in the ED one service per physician, per patient per day has so many "buts" it could choke a pack-a-day smoker. ED coders must deal with patients who receive multiple services on the same day, or who remain in the ED for long periods of time, or whose patient status changes during their time in the ED. To apply E/M codes correctly for repeat visitors, you must thoroughly understand what a separate service entails, how to use modifier -25, and the definition of a day. The three examples that follow will...

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