Wiki Two providers on the same day

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cbosi1

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I know that you cannot bill 2 different providers in the same practice on the same date for E/M codes. We have one provider who did an E/M appointment and another provider who ordered patient labs and both were done on the same date. Do these have to be billed under one provider to be reimbursed or should the two different providers be listed on a single claim or should two different claims be filed? The pay to tax ID is the same for both providers.
My understanding is that both services need to be billed under one provider. Does anyone have any knowledge on this?
 
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Just ordering labs is not enough to bill for an E/M. And you are correct. Two providers with the same practice group and specialty cannot bill separate E/M's. In order to bill out two E/M's on the same day each physician would have to be credentialed with a different specialty. Don't skip over the word credentialed or automatically assume that they are credentialed differently. I have two hand surgeons, but only one was credentialed as as hand specialist. It changes how the office visits are coded.
 
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Orthocoderpgu said:
Just ordering labs is not enough to bill for an E/M. And you are correct. Two providers with the same practice group and specialty cannot bill separate E/M's. In order to bill out two E/M's on the same day each physician would have to be credentialed with a different specialty. Don't skip over the word credentialed or automatically assume that they are credentialed differently. I have two hand surgeons, but only one was credentialed as as hand specialist. It changes how the office visits are coded.
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Thank you for your reply. The E/M is being billed for provider A. Provider B ordered labs to be drawn and they were drawn on the same date as Provider A's appointment. It is the labs that I was questioning; not a separate E/M.
 
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cbosi1 said:
I know that you cannot bill 2 different providers in the same practice on the same date for E/M codes. We have one provider who did an E/M appointment and another provider who ordered patient labs and both were done on the same date. Do these have to be billed under one provider to be reimbursed or should the two different providers be listed on a single claim or should two different claims be filed? The pay to tax ID is the same for both providers.
My understanding is that both services need to be billed under one provider. Does anyone have any knowledge on this?
Click to expand...
Actually you can use XE as a modifier for separate encounter to get paid and both can be billed separately by the different providers.
 
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