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Medical Billing Forum
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2 E/M on same day - different docs
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Topic: 2 E/M on same day - different docs (Read 5607 times)
mkarnes
Newbie
Posts: 3
2 E/M on same day - different docs
«
on:
January 25, 2012, 11:55:17 AM »
One of our general cardiologists saw a patient today and then requested a consultation from our interventionalists/peripheral vascular cardiologist on the same day. If our interventionalist is listed under a separate taxonomy code, then the consultation should be allowed but what modifier would I attach to the consultation since it is on the same day as the initial E/M with the first cardiologist? Btw, this is a commercial insurance patient.
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DMK
Hero Member
Posts: 680
Re: 2 E/M on same day - different docs
«
Reply #1 on:
January 25, 2012, 01:29:59 PM »
Shouldn't be a problem. The 2nd doctor will need to have the UPIN of the referring doctor on his claim. Both can have an E/M code on the same day, even if it's a new patient code.
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mkarnes
Newbie
Posts: 3
Re: 2 E/M on same day - different docs
«
Reply #2 on:
January 25, 2012, 02:18:57 PM »
Thank you!!
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Michele
Administrator
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Posts: 5927
Re: 2 E/M on same day - different docs
«
Reply #3 on:
January 26, 2012, 09:46:55 AM »
DMK, it sounds like they are billing using the same EIN/Group NPI. I don't think they will allow for two new patient codes from the same group on the same date. I've been out of things for a few days so maybe I'm missing something??
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DMK
Hero Member
Posts: 680
Re: 2 E/M on same day - different docs
«
Reply #4 on:
January 26, 2012, 01:43:53 PM »
Re-reading the initial post, I missed that! But if it WAS NOT the same group would both doctors get paid?
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Medical Billing Forum
Re: 2 E/M on same day - different docs
«
Reply #4 on:
January 26, 2012, 01:43:53 PM »
PMRNC
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Posts: 4562
Re: 2 E/M on same day - different docs
«
Reply #5 on:
January 26, 2012, 04:34:57 PM »
I believe they would as long as it wasn't inpatient, but if they are in the same group (same NPI) they will not receive reimbursement for both
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Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com
mkarnes
Newbie
Posts: 3
Re: 2 E/M on same day - different docs
«
Reply #6 on:
January 27, 2012, 11:42:59 AM »
The two doctors are under the same tax id number but have individual NPI numbers. This is in an outpatient setting.
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PMRNC
Hero Member
Posts: 4562
Re: 2 E/M on same day - different docs
«
Reply #7 on:
January 27, 2012, 09:14:39 PM »
If they are in same practice and it's a group practice, no they won't get reimbursed for both.
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Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com
Medical Billing Forum
Re: 2 E/M on same day - different docs
«
Reply #7 on:
January 27, 2012, 09:14:39 PM »
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Medical Billing Forum
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Coding
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Coding
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2 E/M on same day - different docs