Wiki Outpatient Physical Therapy

[Maggi]

Hi
I am trying to get help with a question.
Is it ok to bill medical health insurance and Workers Comp Ins on the same patient, on the same day, if the patient has been seen by two different physical therapists on the same day, at the same clinic.

Senario:
Jane Doe sees Joe,PT @ 1:00 on 4-28-14 for her vertigo and we are billing BCBS insurance.
At 2:20, on the same day, Jane now sees Suzy, PT for her back which is being covered under her Workers Compensation Claim.

Is this ok?
Or does Jane Doe have to see each therapist on different days?
Thank you for the help
Maggi

 

[OCD_coder]

You can certainly see the patient on the same day for completely different problems and bill each claim to the appropriate insurance/carrier.

Oddly enough, I once saw two different work comps billed and a commercial carrier billed all in the same day. It feels weird, but there is nothing wrong or unethical with it as long as the documentation is there to support what service was performed.

Good question, kinda tricky to think about.

 

[cmbradd]

Agreed, two separate body parts, two separate responsible parties, the patient can be seen on the same day by two different therapists and you can bill two separate claims.

The only time billing two separate body parts on the same day would be a problem is if you're billing the same entity. If you are billing the same entity, I have combined the treatment into one claim. The only time that this doesn't work is with Medicare because of the Functional Status reporting codes. I've found it best to see these patients on opposite days for separate body parts.