Medical Billing Forum
Billing => Billing => : ABSLLC May 13, 2019, 10:35:11 AM
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I just received an email from a client's office asking:
So can we open 2 files on this guy ????
PI bill an A code for neck , etc notes and dx only pertaining to that
WC bill another A code for the low back, MT and therapy and notes and dx only relating to that
When the WC injury has resolved to pre injury status, go back to just billing PI
Is this allowed, what is your take? Can an office bill a spinal adjustment on two separate cases for the same date of service and the same encounter?
Thanks for any insights you might have!
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You can but you have to have two separate appointments scheduled for the patient and you must have two charts, documenting each appointment separately. The appointments can be back to back, but they have to be separate. So for example if you schedule appointments every 15 minutes you would put the patient's name in the appointment scheduler two times, one at 1:00 and one at 1:15.
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I'd agree with Michele if these two injuries are different dates not related. If they are same injury date it would depend on your state WC rules, I'm going to say at very least due to rights of recovery laws ONE carrier is primary, IMHO making two appts for purpose of billing two carriers at once seems "shady" for lack of a better word.
You'll want to call both and get adjusters name and I would ask both if they are aware of the other. You'll want all info, claim #'s, DOI, adjusters name, etc.
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Good point Linda. I was assuming that they were two unrelated injuries. We actually see that more than you would think. I've seen it with both PT & Chiros. We were advised by several different WC carriers that as long as the cases were kept separate, and the patient had separate appointments they could be seen on the same day.
I've also seen where it was the same body part but different injuries. In that case the WC Board assigned % of liability to each case and the patient had one appointment, both cases were billed, and they each paid accordingly (40% by one 60% by the other).
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Thank you all for your help.