Wiki E/M

[buuvaneisswaran]

It is an urgent care office visit coding.We have a patient who had come for 2 visit on same day with 10 minutes in between time for E/M for two different conditions to the same doctor .First he had come for injury with Workman compensation Insurance as Primary.After 10 minutes the patient arrived for Sinusitis and got Flu immunization with HMSA as primary insurance.Both visit has E/M.

we shouldn't code 2 E/M on same day and also my confusion is that since we bill to two different Insurance we could bill both the E/M codes for the Patient.Please help me..

 

[PAVALAR]

I think coded with 27 modifier for 2nd visit...

 

[mitchellde]

27 is for outpatient facility only use.
When the patient has work comp and a commercial insurance and two different encounters then you can bill both provided you have the exact scenario you have described. you bill the Work comp only to work comp and the sick visit and flu shot to the commercial. You must have two separate visit notes and each is evaluated only for that reason that the patient was there.