The Record - for physicians and other health care providers to share with their office staffs
Forward to a friend  |  Subscribe  |  The Record Archive  |  Contacts  |  bcbsm.com  |  Print this article
July 2013

BCBSM changes emergency room, trauma services billing

Effective Oct. 1, 2013, BCBSM will process and make separate payments for evaluation and management services received in emergency room or trauma settings when a surgical service is provided in the same visit. This change to processing and payment is part of our ongoing Hospital Outpatient Pricing Strategy Project that we have mentioned in previous articles.

The corresponding ER and trauma evaluation and management procedure codes are: *99281-*99285, *99291, *99292 and G0390. The changes include dates of service on or after Oct. 1, 2013.

The following are sample claims illustrating how services should be billed:

Example 1: All services provided on one date

File Example 1

Example 2: Services provided span more than one day

File Example 1

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2012 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.