Wiki Same day of service, two visits for same problem?

[kls1027]

How do I bill the E/M for two visits, same day of service, same problem, two providers?

Patient has extreme ear pain and comes in and is seen/treated by the NP. She was examined, had ear irrigated without success and then was given prescription for antibiotics.
Later the same day she comes back in and sees MD for same problem, as she was still in extreme pain and wonders if Dr can try to clean ear again. Dr tried to clean ear with peroxide, again no success. Was told to continue the antibiotic treatment prescribed by NP earlier that day.

Since I can only bill one E/M for this problem for the same date of service, who gets the credit? NP who saw her first and prescribed the medicine or the MD who saw her later and only told her to follow the treatment prescribed earlier by NP. Both were same-day-add appointments.

 

[tcowboys07]

Physicians in Group Practice
• Physicians of the same specialty in the same group practice must bill and be paid as a single physician.
• If more than one E/M (face-to-face) service is provided on the same day to the same patient by the same physician or more than one physician in the same specialty in the same group, only one E/M service may be reported unless the E/M services are for unrelated problems. (Refer to instructions for use of the 76 modifier.)
• Instead of billing separately, the physicians should select a level of service representative of the combined visits and submit the appropriate code for that level.

 

[kls1027]

Thank you tcowboys07 -
My question was not how many E/M service can I bill (I understand that it can only be one), my confusion is WHO gets to bill this?
"Since I can only bill one E/M for this problem for the same date of service, who gets the credit? NP who saw her first and prescribed the medicine or the MD who saw her later and only told her to follow the treatment prescribed earlier by NP. Both were same-day-add appointments"

Thank you

 

[rthames052006]

Thank you tcowboys07 -
My question was not how many E/M service can I bill (I understand that it can only be one), my confusion is WHO gets to bill this?
"Since I can only bill one E/M for this problem for the same date of service, who gets the credit? NP who saw her first and prescribed the medicine or the MD who saw her later and only told her to follow the treatment prescribed earlier by NP. Both were same-day-add appointments"

Thank you

This really seems like a question you'd want to ask your billing manager/office manager. Realistically I'd bill this under the MD instead of the NPP, this is just my opinion. I'd also want to check with this patient's carrier, just incase they have some guidance on this matter.