2 visits, same day, same Dr.

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I have a friend who presented me with this question. She works in a Family practice setting. She stated their office had seen a patient on the same day for an auto accident and also for treating the patients blood pressure&DM. She wanted to charge two office visits on the same day. They were going to send the MVA visit to the auto carrier and the BP&DM to patients health ins. It was suggested that they split the charge in 1/2 and send each to the respective ins. co. I would assume that it would be appropriate to append the -25 modifier to the visit of the reason why the appt. was made. Would that be correct? I have never heard of billing the patient for two office visits on the same day. Has anyone experienced the problem before?
 
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MVA non MVA related e/m

From prior experience with an auditor she had recommended the provider to make 2 seperate notes and 2 seperate billing charges. This also helps because a patient may not want them to know NON-MVA related illness.

Thanks!

Ivy Carter, CPC
 

Pam Brooks

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Ivy is correct. You would document two separate visits; submitting each to the appropriate carrier.

If both services were for the same medically-covered (not MVA) condition, then you'd combine both services and bill only once to the health carrier, but since these are different conditions, with separate payer responsibilities, you can bill them both. You don't need a modifier, because they are going to different payers.
 

Michele Price

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Question?

Okay, so if we see a patient for an auto accident related issues and for followup on labs can you charge both insurances for separate evaluation and management CPT codes just by separating the soap notes?

We see patients all the time for non related diagnoses and auto related diagnoses. This would warrant a separate E/M code for each insurance?

If that is not what you meant then what do we do when we see a patient for, lets say, hypertension, CAD, Goiter, Hyperlipedemia and go over lab results and add and continue meds and then see them for pain associated with the auto accident and order diagnostic testing for the auto and health problems?
 

swilliams2

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2 visits

Yes, have the provider document two notes and only document in each what is releveant to the diagnosis being evaluated (no double dipping). Then, yes, you can bill two visits-one to each carrier.
 
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