2 e/m on same day?

puggles

Networker
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59
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0
We had a patient come in to be seen for a work comp injury to the eye and while there he told the doc that he was sick and thought had strep. So how are we really supposed to be billing/coding this? Can we file an e/m code with the workcomp ins and then the other e/m with the ins carrier? I dont think this is right but not sure what to do, any suggestions?
 

Orthocoderpgu

True Blue
Local Chapter Officer
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855
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Salt Lake North
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You would'nt file a claim for the sickness with the Workman's comp carrier unless it was directly related to the injury. Otherwise, you would need to seperate the workup done for the illness and seperate it out from the injury. If it has a seperate HX,EXAM,MDM you can bill it to his private ins with a -25. My guess is that it would probably be a 99212. Hope this helps.
 

sbicknell

Guest
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Build 2 separate accts for your patient. He will have a personal acct and a separate WC acct. Office is very heavy on WC and some patients have several WC accounts due to mutiple DOI and claim/case #s

Example: If pt presents for WC care (back) and then says "oh I have sinus drainage". The Physician documents a WC note (acct #2032) for the WC care and then documents a separate note for the personal acct (acct #128) for the sinusitis

WC is not included in the "1 E&M visit per day"
 
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