Medical Billing Forum

Billing => Billing => Topic started by: Yesica on April 06, 2011, 05:40:36 PM

Title: Two Office Visits on the Same Day
Post by: Yesica on April 06, 2011, 05:40:36 PM
I know we have seen this question a million times but I need help in regards this patient that came in twice in the same day.

Patient was schedule for Chemotherapy due to low blood counts patient didnt received chemotherapy but did receive an injection of Leukine and Procrit. Patient was schedule the same day to go to the Hospital for a Venous Doppler Lwr Bilateral.

The patient came back again to get an injection of Arixtra for Thrombosis embolism. Pt was thought how to self inject and pt was a given a prescription.

Help please. How do you bill for two office visits in one day?
                     
Title: Re: Two Office Visits on the Same Day
Post by: Michele on April 07, 2011, 07:05:19 AM
I'm not a coder, but wouldn't you just make it one OV but consider the time and other criteria from both visits when choosing the level?  My other thought is bill both, expect a denial, and appeal.  But I don't think that most insurance carriers will allow 2, even with the details.   ??? ???

Any coders out there??
Title: Re: Two Office Visits on the Same Day
Post by: rdmoore2003 on April 07, 2011, 12:08:22 PM
I am Michele.   That sounds good to me.   You would code as a more extensive ov.
Title: Re: Two Office Visits on the Same Day
Post by: Yesica on April 07, 2011, 01:55:29 PM
Can I also use prolonged visits. Both visits were considered office visits level 4. Thats why am asking.
Title: Re: Two Office Visits on the Same Day
Post by: rdmoore2003 on April 07, 2011, 02:10:49 PM
yes
Title: Re: Two Office Visits on the Same Day
Post by: rdmoore2003 on April 07, 2011, 02:12:09 PM
yes u can use level 4 (only once though) and you could go even 1 more level if needed
Title: Re: Two Office Visits on the Same Day
Post by: Yesica on April 07, 2011, 05:49:24 PM
I dont think I made question clear.

Both of the visits were Office visit level 4.

AM visit Level 4

PM Visit level 4

How can i combine these two. I can I bill a office visit level 5 and prolonged services?

Do I make it clear? ???
Title: Re: Two Office Visits on the Same Day
Post by: aksharhealth on April 11, 2011, 11:23:43 AM
I dont think I made question clear.

Both of the visits were Office visit level 4.

AM visit Level 4

PM Visit level 4

How can i combine these two. I can I bill a office visit level 5 and prolonged services?

Do I make it clear? ???
Thats the most you can bill is level 5. You cannot bill 2 office visits for same day. No insurance will pay 2 visits for same doc. If 2 visits are provided by 2 different docs and 2 different conditions then some insurances do pay but not Medicare. If it is not Medicare then I will send paper claim along with cover sheet and office notes reqeusting xx% increase in payment. Make sure the dx are billed at highest level. I hope this might help you. This is JMO. I am not a certified coder.
Title: Re: Two Office Visits on the Same Day
Post by: PMRNC on April 11, 2011, 05:21:44 PM
.
Quote
If 2 visits are provided by 2 different docs and 2 different conditions then some insurances do pay but not Medicare.


And it will depend on who gets their claim in first. Carriers will pay the one they receive first!
Title: Re: Two Office Visits on the Same Day
Post by: sl1181 on June 04, 2011, 05:12:46 PM
You can try and bill 99354 prolonged service it must be documented in the chart how much time was spent with the patient and many insurance company ask  for notes but they do pay it.
Title: Re: Two Office Visits on the Same Day
Post by: pattil88 on June 05, 2011, 09:19:28 AM
Two office visits on the same day:
 
"Medicare will only pay for two office visits on the same day, if they are unrelated.  A second office visit billed on the same day to the same patient for the same condition is not payable.  If a patient is seen in the morning with an acute or chronic problem, sent home from the office, and returns later either at the physician's request or because their symptoms are worse, report only one visit.  The level of service selected may be based on the documentation for both services.  If the second visit is all provider face-to-face time with the patient, consider using prolonged services codes." 

(From Chapter 12 in the Medicare Claims Processing Manual)