Primary Care Coding Alert

Don't lose sleep worrying over denials for multiple same-day office visits with guaranteed ways to capture your FP's work. Not sure when you should add on another E/M code? Check out these factors to avoid denials. Same Problem Equals the Same Code According to Quinten Buechner, president of ProActive Consultants in Cumberland, Wis., most payers follow Medicare guidelines on claims. Therefore, when considering multiple E/Ms, let the Medicare Claims Processing Manual (MCPM) (www.cms.hhs.gov/manuals/downloads/clm104c12.pdf) serve as your most useful guide. Check out these coding rules: • Physicians who are in a group practice and have the same specialty cannot code separately for their E/M services if they provided those services to the patient on the same day unless the E/M services were for unrelated problems, states MCPM, Chapter 12, Section 30.6.5. • Since Medicare otherwise considers that E/M services done in this situation are directly related, rather than reporting them [...]