2 IP visits same day, different facility

debwoods65

Networker
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Location
Overland Park, KS
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I believe I know the answer but just want to make sure...Our practice provides service to several outlying hospitals. If one of our providers see a patient at an outlying facility and transfers them into the city, then a different one of our providers sees the patient at the new facility can 2 E&M services be billed for or only one? Same day, same practice but diff physician, same specialty, same issue but different facility.
 

aaron.lucas

Expert
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Location
Cherry Hill, NJ
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if it's two different people (the physicians) then you can bill two E/M services. if the patient is being transfered (not admitted to the first hospital) then you could bill one outpatient hospital visit, then one inpatient for the admission to the other. that's assuming the patient is being admitted at the second facility of course. hope this helps!
 

LLovett

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Are they the same specialty and same group?

If they are the same specialty and the same group then you have to combine their documentation and just bill 1 service.

Providers of the same specialty in the same group are seen as the same provider when they provide services to the same patient on the same day, regardless of the setting where the services were provided.

If they are different specialties or the same specialty but in different groups then you are fine to bill each service stand alone.


Laura, CPC, CPMA, CEMC
 
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