Forum - Questions & Answers

Sep 9th, 2014 - krissysmash 3 

Two physicians, both gynecologist, but two diagnosis on the same day?

Patient is scheduled for two office visits with two gynecologists on the same day. Will insurance cover both office visits, even though they will be for two different diagnosis?

Sep 9th, 2014 -

re: Two physicians, both gynecologist, but two diagnosis on the same day?

If their within the same tax ID# and or same practice, absolutely not. You need to combine the visit and bill the a higher E&M w/the more complicated DX as the first listed.

Sep 9th, 2014 - krissysmash 3 

re: Two physicians, both gynecologist, but two diagnosis on the same day?

They are not in the same practice, tax id or affiliated in any way. The only common factor is they are both gynecologist by specialty. One is performing the annual well visit. The other is a new patient visit to consult about possible hystorectomy/removal of implanted device due to pain.

Sep 9th, 2014 -

re: Two physicians, both gynecologist, but two diagnosis on the same day?

in that case then yes, each provider can bill for their services, whether or not both services are gonna get paid highly depends on the patient's insurance. I would bill the WWE with the correct code range of the patients age for new patients 99381-99387 or established 99391-99397 with the V72.31 as long as its not a adolescent. I would be careful about using the consult codes 99241-99245 as MCR is doing away with those codes and alot of payers are following their guidelines. the Blues will still pay on them though. hope this helps:)

Sep 9th, 2014 - krissysmash 3 

re: Two physicians, both gynecologist, but two diagnosis on the same day?

I know I used the word consult, but didn't mean as far as the consult code. It would be a new patient visit.

Sep 9th, 2014 - krissysmash 3 

re: Two physicians, both gynecologist, but two diagnosis on the same day?

Insurance is United Health Care

Sep 9th, 2014 -

re: Two physicians, both gynecologist, but two diagnosis on the same day?

as a coder I don't follow what insurances pay, just try to keep the practice in complicance with coding, but good luck:)



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