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Wiki Two E/Ms on same DOS
- Thread starter Partha
- Start date
mitchellde
True Blue
only if one is a different specialty and not for Medicare or any payer following Medicare's 2010 policy on consults,
Thanks Debra
Yes Medicare will not accept consults...
If they are non-Medicare and of different specialties, do we need a modifier to justify...?
Thanks again!
mitchellde
True Blue
no there is no modifier, just the documentation to show that the requirements for a consult have been met, the three Rs
mitchellde
True Blue
No that would be for same physician you have two different physicians so 2 different 1500s.
mitchellde
True Blue
but the rendering in box 24J and the sig on line 31 are different for each one. This should be going out as two separate 1500s so there is no 25 modifer to be appended:
25 modifier significant and separately identifiable E&M by the SAME physician on the same day as a procedure or service.
25 modifier significant and separately identifiable E&M by the SAME physician on the same day as a procedure or service.
mitchellde
True Blue
but the rendering in box 24J and the sig on line 31 are different for each one. This should be going out as two separate 1500s so there is no 25 modifer to be appended:
25 modifier significant and separately identifiable E&M by the SAME physician on the same day as a procedure or service.
25 modifier significant and separately identifiable E&M by the SAME physician on the same day as a procedure or service.
coderforlife
Guest
2 e/m's same day different physician
how about this? Dr. one sees the patient for wrist pain and does a 99212 ov and then sends patient to see Dr. two who has a sub-specialty for hands and completes a 99213 ov. Same day, same tax id, can we bill both encounters? I realize they would both need to provide separate notes, would you have to create two separate encounters also? Also same insurance carrier.
coderforlife
how about this? Dr. one sees the patient for wrist pain and does a 99212 ov and then sends patient to see Dr. two who has a sub-specialty for hands and completes a 99213 ov. Same day, same tax id, can we bill both encounters? I realize they would both need to provide separate notes, would you have to create two separate encounters also? Also same insurance carrier.
coderforlife
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