Wiki 2 E&M, same day, same Doc

[jdarrington]

We have an established patient who was referred to us for a new problem. The patient was already scheduled for f/u, and the doc addressed the referral in the same visit. Essentially the consultation & follow up were both done at the same time in the same record. Can I bill for both E&Ms? Would a modifier be needed?

 

[debflutter]

You cannot bill for 2 E&M codes for the same physician on the same day unless there are two different carriers and two different diagnoses. Such as, workers' comp for back pain and commercial insurance for hypertension.

 

[jdarrington]

That's what I thought, but I haven't been able to find any documentation supporting this. Can you point me in the right direction?

 

[Narayana]

NO

second assessment were taken just in the same visit so you can combine the both the documentations and bill as one which might help in arriving to one level higher.