Wiki billing multiple visits

[PattyGreen]

If 2 different physicians from 2 different sub-specialties of Ophthalmology see the same patient on the same day with 2 different diagnosis codes can both visits be billed to insurance? For example, a Retina dr. sees pt. for diabetic retinopathy/AMD and also sees a Cornea dr. for cataract eval. to discuss extraction can both bill a visit? Does one need to bill an E/M and one bill an eye code? Thanks for any info!!!

 

[btadlock1]

If 2 different physicians from 2 different sub-specialties of Ophthalmology see the same patient on the same day with 2 different diagnosis codes can both visits be billed to insurance? For example, a Retina dr. sees pt. for diabetic retinopathy/AMD and also sees a Cornea dr. for cataract eval. to discuss extraction can both bill a visit? Does one need to bill an E/M and one bill an eye code? Thanks for any info!!!

They should both bill for what they did. As long as their work and the medical necessity are documented, there's no reason both of them can't get paid. You may have to submit an appeal with records if one gets a denial, though. Hope that helps!

 

[rhotonscott]

i agree with Brandi. Even if within global for one sub-specialty surgery, you can bill E/M's for another sub-specialty with -24 modifier if the reason for the visit and the service performed warrants it.