Wiki 2 E/M Codes Same Day/Same Encounter

crjones1980

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A physician has asked me to bill 2 E/M codes for one patient on the same day. The patient was seen one time on this DOS. The issue is that the patient has a work comp injury as well as underlying medical issues, and instead of the patient having separate appointments, they only want to come in one time and be treated for everything. The physician has dictated 2 separate notes, but the patient was seen only one time. This seems like double dipping to me.

I have found conflicting answers regarding this policy. I found an old policy on the CMS website that states "...carriers may not pay two E/M office visits billed by a physician 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..." Any advice/links to policies anyone could provide would be greatly appreciated.

Thanks so much for any assistance you can offer!

Cammie Jones-Parrish, CPC
 
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