Forum - Questions & Answers

Mar 5th, 2014 - TerryC 39 

two visits same day

We had a patient that was seen at the end of the day, with one of our F/P doctors. The visit carried on over to our urgent care, where the patient was given a IV and also followed up by our F/P urgent care doctor. Can both doctors bill an E/M visit. Or should just the first doctor bill? Thanks

Mar 5th, 2014 -

re: two visits same day

Normally, an E/M code is a per day CPT® code. You will need to consider the insurance company you are dealing with first. Also, does your urgent care center have a separate tax ID#? and/or provider number? This can make a difference in your billing. Do both providers have their own provider's number with this insurance? The last question I have is, would the last care be considered Critical Care?

In the past, for the same practice, I have seen this non-critical care services handled several different ways. 1) If this encounter shares the same diagnosis, we would allow the provider who performed the majority of the care to bill for services rendered. When selecting the CPT® code, consider the documentation from both providers. Or, 2) Bill both codes manually (if you are able to do so) with the notes attached for the insurance company to review. Any change to the questions above can change this decision.



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