Medical Billing Forum

Coding => Coding => : CPGCardio October 08, 2012, 02:39:18 PM

: Med Card and EP doc same group
: CPGCardio October 08, 2012, 02:39:18 PM

Medical cardiologist sees patient and EP doc from same group sees patient same day. Patient has medicare.    Can 2 99221-99223 codes be billed on same day if different dx codes are used.   would a 25 modifier be appropriate or needed for the EP consult?   

: Re: Med Card and EP doc same group
: Michele October 09, 2012, 11:23:08 AM

You can bill the two codes but I don't believe Medicare will allow two visits from drs in the same group (billing under same EIN/Group NPI) on the same date of service.  I do not believe the 25 modifier will make a difference with two 992** codes.

: Re: Med Card and EP doc same group
: PMRNC October 09, 2012, 11:38:49 AM

Medicare won't pay for more than one consult per day, I believe, even if it's done within a diff group/provider,  They will pay the first one that is received.