CMS Pub. 100-04, ch. 4, § 180.6

Dates

(Rev. 2361, Issued: 11-25-11, Effective: 01-01-12 and 04-01-12, Implementation; 04- 02-12)

Emergency room (ER) services provided by hospital outpatient departments (OPPS &

Non-OPPS) should be billed in the following manner:

• Emergency room services are reported under the 045x revenue code

• The line item date of service for the ER encounter is the date the patient entered

the ER even if the patients encounter spans multiple service dates

• For all other services related to the ER encounter (i.e., lab, radiology, etc) the line

item date of service reported is the date the service was actually rendered

Note: For patients in a Skilled Nursing Facility (SNF) see Chapter 6, Section 20.1.2.2

“Emergency Services” for special billing instructions using the ET modifier. Chapter 6,

Section 20.1.2.2 applies to hospital ER services spanning multiple service dates that are

provided to patients in a Part A SNF stay and related CWF SNF consolidated billing

edits.

For patients with end stage renal disease (ESRD) see Chapter 8, Section 50.1.6 for billing

instructions requiring the use of the ET modifier. Chapter 8, Section 50.1.6 applies to

hospital ER services spanning multiple service dates including laboratory services.