Wiki Can we bill 99233 twice on same day

[bsrinivasarao777]

Hi all, Here I am new to denial management and I need your support on below scenario.

As per my documentation, provider A had rendered 99233 service on 030615 & 030715 with the dx sequence 434.91,250.00,585.9 & 780.09 and for the same date of services provider B also rendered 99233 service with the dx sequence 431,780.09 & 348.5.
I went through the specialty of the above mentioned providers, both are different specialties
In this case the provider B charges got denied as a duplicate and I tried with an appeal again it got denied as non-covered charges.


Please I need your suggestion on above mentioned scenario,

Thanks.

 

[Xieb]

Concurrent Care

Hello,
According to the New York Workers Compensation Fee Schedule Ground Rule 6, Concurrent Care: "When more than one physician treats a patient for the same condition during the same period of time, payment is made only to one physician, the one whose specialist is most relevant to the diagnosis". Payment is usually allowed for one E/M service per day.

Hope this helps!

 

[mitchellde]

If the two providers are of different specialties then they should be seeing the patient for different concerns. In the inpatient setting, each physician should keep to the diagnosis for why they are attending the patient, not every diagnosis the patient has. So it will come down to each individual note and what the provider documented as to why they were there for that encounter.

 

[bsrinivasarao777]

Thanks

Thanks for your suggestion on this

 

[1formissy]

Not normally, unless there are two different providers under two different Tax ID's.

 

[bsrinivasarao777]

Hi

In this scenario there are two different providers(different Specialty) done E&M services. Still the claim didnt get paid so we have given appeal documentation again.