I work on the Edit team for a hospital and we recently got a denial from Medi-Cal stating they will not pay using the combination E/M 99284&99285 for the same date of service. They want us to resubmit using 99283. Is anyone familiar with Medi-Cal.

Our patient was seen in the emergency department Hospital billed a 99284 and the physician billed a 99285.

We either have to take the E&M off or bill the lower code or write it off.

Thank you,