Found this on Codapedia. Hope it helps. Thanks for the opportunity for me to learn as well.
Two office visits on the same day
Medicare will only pay for two office visits on the same day, if they are unrelated. A second office visit billed on the same day to the same patient for the same condition is not payable. If a patient is seen in the morning with an acute or chronic problem, sent home from the office, and returns later either at the physician's request or because their symptoms are worse, report only one visit. The level of service selected may be based on the documentation for both services. If the second visit is all provider face-to-face time with the patient, consider using prolonged services codes. Review the rules for that in the Codapedia article on prolonged services.
From the Medicare Claims Processing Manual, Chapter 12
B Office/Outpatient E/M Visits Provided on Same Day for Unrelated Problems
As for all other E/M services except where specifically noted, carriers may not pay two
E/M office visits billed by a physician (or physician of the same specialty from the same
group practice) for the same beneficiary on the same day unless the physician documents
that the visits were for unrelated problems in the office or outpatient setting which could
not be provided during the same encounter (e.g., office visit for blood pressure
medication evaluation, followed five hours later by a visit for evaluation of leg pain
following an accident).
- See more at:
http://www.codapedia.com/article_12...ble-on-the-same-day-.cfm#sthash.udNyiFE1.dpuf