tci Part B Insider - 2003 Issue 11

Reimbursement: An ED Visit and a Hospital Admission on the Same Day? Earn Proper Payment

How can you code for optimal reimbursement if the surgeon sees a patient in the emergency department (ED) and subsequently admits him or her as an inpatient? Although general coding principles prohibit reporting two E/M services on the same date of service, there is a way to receive payment based on the total effort the surgeon provides.Neurosurgeons often see patients in the ED and, after examination, admit them to the hospital. The pre-admission examination can be extensive, lasting an hour or more in some cases. Under most payers' guidelines (and as explicitly stated in the Medicare Carriers Manual...

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