MD VISIT AND DIABETES EDUCATION

[mdenton]

CAN WE BILL FOR AN M.D. VISIT 99213 FOR SINUSITIS AND A G0108 DIABETES EDUCATION VISIT FOR DIABETES ON THE SAME DAY?  ANY MODIFIERS NEEDED?
THANK YOU!
MARSHA

[Michele]

You certainly can bill for them if those are the services that were done, it's a matter of if they will be reimbursed, which will vary from carrier to carrier and plan to plan.  I'm not aware of any modifier that would be specific for that situation.

[mdenton]

THE VISITS WOULD BE PERFORMED BY TWO DIFFERENT PROVIDERS AT THE SAME LOCATION.  SEE PRIOR POST REGARDING MY QUESTION.  THANK YOU FOR ANY HELP YOU CAN GIVE ME.
MARSHA

[PMRNC]

What Michele said was accurate:

You certainly can bill for them if those are the services that were done, it's a matter of if they will be reimbursed, which will vary from carrier to carrier and plan to plan.  I'm not aware of any modifier that would be specific for that situation.

Some carriers will ONLY pay for one E&M visit per day. You can bill for them but reimbursement is going to depend on the carrier.

[Michele]

Even if it is two different providers, if they are part of the same group then the billing info, EIN, Group NPI, etc, will be the same and they will process according to the plans provisions.  If the plan allows it, then they will pay.