Wiki 2 E/M on same day?

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Earnose

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Our practice employees and ENT/Facial Plastic and a Dermatologist that work in side by side offices. Patients often see the Dermatologist for one thing and than hop next door to see the ENT out of convience i guess resulting in 2 E/M codes being billed on the same day. We use the same billing system for both doctors and we bill under the same Tax Id. This causes the claims to be held because of two E/M services. I get a rule fired stateing we could use a 76 or 77 modifier but i really don't feel those apply and i was told by the academy of facial plastics that should do away with one of the E/M. Just wanting to know other opinions.
 
If you have 2 different specialties it shouldn't be an issue. You could have several different E/M for the same tax id on the same date if they are different specialties. I used to work in a very large multispecialty group and it was not uncommon for a patient to come in and see 3 different doctors in one day (example GYN for pap, Endocrinologist for DM, Cardiologist for HTN). One stop shopping in the medical field.

How your providers are credentialed is the first thing you need to find out.

If for some reason they are not credentialed under different specialties you would only have 1 E/M service but it would be based on the combined documentation of both notes.

Based on what you have posted this sounds like an internal billing system glitch, not a correct/incorrect coding situation but it is always best to cover all the bases before you tell whoever is over that system it is actually the problem instead of the coding.

Laura, CPC, CEMC
 
I have never used or heard of using a 27. I am fairly new at this. So patient saw two differant doctors with two differant specialties on the same day i can use the 27 on one of the E/M's? Will it make a differance if one of the diagnosis is the same?
 
27 is for outpatient hospitals.

If they are credentialed by specialty no modifier is needed or appropriate in the case of 2 E/M services by different specialties in the same group.

Laura, CPC, CEMC
 
We too often have patients come in and see several MD's of different specialties on the same day. All of the physicians in our office are on same Tax ID #. No Modifier needed. No issues w/payment.
 
Different fee schedules for different specialties?

My question is can you bill a different fee for 99213 if the specialty is different? Same Tax ID, large group. For example, can you bill one fee for 99213 for a Family MD and a different fee for 99213 for an orthopedist and a different fee for a neurologist?
We were just curious. We work for a large Orthopedic practice who has/may have different specialties under one tax ID number.
Thanks so much in advance.
Lynn Spille, CPC
 
I agree that you have to check on the credentialing of the physician's first. You may have an issue there.
 
We are a General Surgery practice with a subspecialty ColoRectal surgeon. We have often billed 2 e/m visits. We do not use a modifier and have no problem getting paid.
 
Where would be the best resource for documentation related to appropriateness of 2 E&M on the same day? We are in Substance Abuse and see patients for Medication Assisted Treatment. Sometimes we have patients that need to be seen for another issue in addition to their MAT service. (i.e. tooth abscess, burn injury... really anything urgent care nature)
 
kwright73 said:
Where would be the best resource for documentation related to appropriateness of 2 E&M on the same day? We are in Substance Abuse and see patients for Medication Assisted Treatment. Sometimes we have patients that need to be seen for another issue in addition to their MAT service. (i.e. tooth abscess, burn injury... really anything urgent care nature)
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Hi, how did you end up billing for these services? I have the same scenario
 
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