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Primary Care Coding Alert

Reader Question:

Insurers May Require Bundling Same-Day E/M Services

Published on Thu Apr 05, 2012

Question: Can we bill two office visits on the same day? We reported 99214 twice for the same date of service but used different diagnoses and insurance paid one and denied the other.Tennessee Subscriber Answer: It depends on what the diagnoses were, but most insurers will not allow you to report two office visits on the same date. These payers base their regulations on Medicare rules, which generally prohibit you from billing these together. According to MLN Matters article MM4032, "Carriers MAY NOT pay two E/M office visits billed by a physician (or physician of the same specialty from the same group practice) for the same beneficiary on the same day unless the physician documents that the visits were for unrelated problems in the office or outpatient setting which could not be provided during the same encounter (e.g., office visit for blood pressure medication evaluation, followed five hours later by [...]
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