DebbLord
Guest
Good afternoon,
I am in need of some help, as there is a lot of confusion when searching for the correct answer.
I work for an Orthopedic office where we have an Orthopedic surgeon and a DO. Our MD provider saw a patient in the morning for his shoulder, then the patient came back in the afternoon to see our DO for an injection in his hip.
When researching how to bill both visits, I came across several different answers. The patient has Medicare and it stated that two E/M visits cannot be billed in the same day UNLESS the patient was seen for different problems. Another answer (from 2008) stated to append modifier 76 on the second visit, which was done by our DO. My billing software is stating that Modifier 76 is not appropriate.
Do I bill them both and not append any modifier aside from the 25 modifier for the afternoon visit? Or would I append a 24 modifier along side of the 25 modifier, so show that the second visit is for a completely different problem than the first visit?
I also saw that I should combine the office notes for each E/M and choose the appropriate level to summarize both visits.
Thank you for any help any of you are able to give for this.
Debb
I am in need of some help, as there is a lot of confusion when searching for the correct answer.
I work for an Orthopedic office where we have an Orthopedic surgeon and a DO. Our MD provider saw a patient in the morning for his shoulder, then the patient came back in the afternoon to see our DO for an injection in his hip.
When researching how to bill both visits, I came across several different answers. The patient has Medicare and it stated that two E/M visits cannot be billed in the same day UNLESS the patient was seen for different problems. Another answer (from 2008) stated to append modifier 76 on the second visit, which was done by our DO. My billing software is stating that Modifier 76 is not appropriate.
Do I bill them both and not append any modifier aside from the 25 modifier for the afternoon visit? Or would I append a 24 modifier along side of the 25 modifier, so show that the second visit is for a completely different problem than the first visit?
I also saw that I should combine the office notes for each E/M and choose the appropriate level to summarize both visits.
Thank you for any help any of you are able to give for this.
Debb