Wiki PMR, internal medicine and physical therapy

[Colliemom]

Good morning,

One of my coworkers was just asked the following questions, and I do not have any experience with coding for internal medicine visits and physical therapy codes on the same day. We would really appreciate it if you guys could weigh in with your opinions.

Dr. O?Brien is a PMR (Physical Medicine and Rehabilitation) physician and not an Internist, so he is a different specialty, but within the same group.
Also, the physical therapists are completely different, but they are also within the same group as Dr. O?Brien and the PCP?s.

1. If a patient sees physical therapy (97110, 97140, 97101) and they determine the patient needs to see Dr. Obrien on the same day. Can this be done on the same day/will both visits be paid? Dr. O?Brien bills E/M codes and will bill with the same diagnosis.

2. The PCP sees a patient and bills E/M code with diagnosis hypertension and the patient is scheduled same day for Dr. Obrien (he bills E/M code) different diagnosis leg pain. Can this be done on the same day/will both visits be paid?

3. The PCP sees a patient and bills for an E/M for an urgent visit diagnosis leg pain and the patient is scheduled same day for Dr. Obrien (E/M code) same diagnosis. Can this be done on the same day/will both visits be paid?

4. The PCP sees a patient and bills for an E/M for an urgent visit diagnosis leg pain and the patient is scheduled same day for Physical Therapy (97110,97140,97101 ? NO E/M code). Can this be done on the same day/will both visits be paid?

5. We also have patients scheduled to see PCP for medical related issues and then they are also seen by the Physical Therapy for a workers comp/Auto injury. Can this be done on the same day/will both visits be paid?


thank you

 

[mhstrauss]

Good morning,

One of my coworkers was just asked the following questions, and I do not have any experience with coding for internal medicine visits and physical therapy codes on the same day. We would really appreciate it if you guys could weigh in with your opinions.

Dr. O?Brien is a PMR (Physical Medicine and Rehabilitation) physician and not an Internist, so he is a different specialty, but within the same group.
Also, the physical therapists are completely different, but they are also within the same group as Dr. O?Brien and the PCP?s.

1. If a patient sees physical therapy (97110, 97140, 97101) and they determine the patient needs to see Dr. Obrien on the same day. Can this be done on the same day/will both visits be paid? Dr. O?Brien bills E/M codes and will bill with the same diagnosis.

2. The PCP sees a patient and bills E/M code with diagnosis hypertension and the patient is scheduled same day for Dr. Obrien (he bills E/M code) different diagnosis leg pain. Can this be done on the same day/will both visits be paid?

3. The PCP sees a patient and bills for an E/M for an urgent visit diagnosis leg pain and the patient is scheduled same day for Dr. Obrien (E/M code) same diagnosis. Can this be done on the same day/will both visits be paid?

4. The PCP sees a patient and bills for an E/M for an urgent visit diagnosis leg pain and the patient is scheduled same day for Physical Therapy (97110,97140,97101 ? NO E/M code). Can this be done on the same day/will both visits be paid?

5. We also have patients scheduled to see PCP for medical related issues and then they are also seen by the Physical Therapy for a workers comp/Auto injury. Can this be done on the same day/will both visits be paid?


thank you

Since the PMR doc, the PCP doc, and the therapist are all registered as different specialties with their individual NPI's, you shouldn't have any problems billing/getting paid for any of these situations. Especially the last one, since the PCP claim will go to medical insurance, and the PT claim will go to the W/C or auto ins.