Author Topic: AM & PM visit for same procedure  (Read 1385 times)

dfranklin

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AM & PM visit for same procedure
« on: September 30, 2010, 11:33:04 PM »
How do you handle billing when a patient came in the AM and then again in the PM for 2 seperate services?  I have a chiro that provided 98941 in the AM and then again to the patient in the PM?  It was submitted to us on 2 seperate superbills so it was billed out as 2 seperate claims for the same DOS so obviously Medicare denied the 2nd as a duplicate.  Can we just add a modifier for the second (PM) visit? What modifier? Is it ok they are on 2 seperate claims or do they need to be combined on 1?

Thanks!

PMRNC

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Re: AM & PM visit for same procedure
« Reply #1 on: October 01, 2010, 06:30:22 AM »
I would think it would be 2 "units" and I still don't think Medicare will cover 2 of the same on one day.
Linda Walker
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Michele

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Re: AM & PM visit for same procedure
« Reply #2 on: October 01, 2010, 06:50:14 AM »
I think Linda is correct.
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PMRNC

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Re: AM & PM visit for same procedure
« Reply #3 on: October 01, 2010, 06:51:59 AM »
This comes up with mental health billing all the time.. sometimes the patient will receive therapy at one time and might come back in later, even with submitting proper documentation the carriers usually don't pay for the same service twice in one day.
Linda Walker
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DMK

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Re: AM & PM visit for same procedure
« Reply #4 on: October 01, 2010, 10:28:13 AM »
I hate to burst the Chiro's bubble, but I don't think there's ANY insurance that will pay for 2 chiro visits in one day, for ANY reason.  Not even PI insurance will cover that.  And if he/she has the patient set up on a "plan" it should all be part of the plan.