Medical Billing Forum

Coding => Coding => : tphipps February 27, 2018, 11:47:22 AM

: billing 2 body parts on the same day
: tphipps February 27, 2018, 11:47:22 AM
I work at a Physical Therapy practice and we are getting an influx of patients who need to be seen for 2 separate body parts and want to do so in the same visit.  This seems to always cause a billing nightmare and most often get denied for duplicate claims because we create a separate case for each body part so they go out on 2 different claim forms.  Our PT doesn't want to inconvenience our patients by asking them to come on different days.  Anyone else have this issue and found an easy way to resolve it?
: Re: billing 2 body parts on the same day
: Michele February 27, 2018, 01:13:07 PM
I would bill them on the same claim, but showing the dxs for the different body parts on the appropriate lines.  I would also use the appropriate modifier to indicate that the services are separate.  With that being said, they still will most likely be denied.  You can appeal them with notes and an explanation, but it may not help.  Another option is to contact the insurance ahead of time and ask if there is anyway to treat the patient for both issues on the same date.  They may authorize it that way, avoiding the denial.
: Re: billing 2 body parts on the same day
: BikhamHCare April 17, 2018, 06:13:29 PM
If it is the NP, I could give you some advise. However, an expert consultancy is still mandatory. Here how it goes. If you are visiting for NP for two different reasons and that too, on the same day; Modifier 25 could be your best shot. You will be asked for NOPs that falls in the same tax ID. Hope this helps.
: Re: billing 2 body parts on the same day
: PMRNC April 18, 2018, 05:06:13 PM
If it is the NP, I could give you some advise. However, an expert consultancy is still mandatory. Here how it goes. If you are visiting for NP for two different reasons and that too, on the same day; Modifier 25 could be your best shot. You will be asked for NOPs that falls in the same tax ID. Hope this helps.


HUH?  She said PT not NP. Michele had the better advise based on this specialty. I'd just ask that it's best to "inconvenience" the patient once you tell them their insurance may  not cover both on the same day, better to be inconveninced with time rather than a large bill :)