Correctly Code These Separate but Equal Encounters
Question: A parent came in with their twin children, who were showing signs of having colds. Upon examination, the pediatrician diagnosed one of the twins with acute sinusitis and the other with strep throat. Do I report this as one encounter or two? AAPC Forum Participant Answer: You would report these as two separate encounters. Because each patient received an individual evaluation, treatment, and care based on their specific needs, they should be billed separately. Also, despite the fact that both children were examined in the same room at the same time, they received different diagnoses. All of these reasons mean it’s necessary to document each twin’s evaluation and management (E/M) service individually. This is to accurately represent the care provided by the healthcare professional and to guarantee appropriate payment for the separate patients. Lindsey Bush, BA, MA, CPC, Production Editor, AAPC
