Avoid Billing Mistakes in Multi-Location Practices
Question: If a patient receives an evaluation and management (E/M) service at one practice location and is referred to a different location within the same practice for diagnostic testing, should the E/M service and test be billed on separate claims, or combined on a single claim? AAPC Forum Participant Answer: You will need to submit a separate claim for each location. Submit the first claim so the E/M service from the provider who ordered the test from the initial location receives payment for their work. The second location should submit a claim for the test, but it should not report an E/M service since the patient was already evaluated, and the test was ordered during the first visit. Make note: The above scenario is presuming that at the second location, the patient did not bring up a separate issue with the doctor performing the test. If the patient did ask the testing doctor about a separate issue that’s unrelated to the test at the second location, and that doctor took the time to treat the new issue, the visit would support an E/M as long as you also append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) to show that the E/M was unrelated and reasonable. Lindsey Bush, BA, MA, CPC, Production Editor, AAPC
