Wiki e/m visit help

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lsilbaugh

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good morning
pt comes in for their 6 month check up for chronic illness and also a check up for their MVA.

How would this be coded? Provider is trying to do two encounters for this
 
Hello,
I am not an expert yet. My thoughts: I would combine all Dx in one visit By the same MD on the same DOS. Dx that were assessed, managed, treated, discussed. There is no need to create two charges. The second one might be denied as duplicate.
 
I am interpreting your question as MVA = visit billed to no fault, and also had treatment of an unrelated chronic problem being billed to commercial payor. In those situations, best practice is to have 2 notes. The no fault visit would contain only the relevant information and leveled by that care. The commercial payor visit would contain only the relevant chronic problem information and leveled by that care.
If you have only 1 document, it gets rather tricky from several angles. From a compliance perspective and the no fault carrier should not have information about the patient's unrelated chronic problem and the commercial payor should not have information about their motor vehicle injury. It is also difficult to level 2 separate visits from one piece of documentation.
If I am interpreting your question correctly, this question does come up periodically (usually with WC and commercial but same concept) and if you search the forums you should find more information.
 
I agree with Christine. It is best to either have the patient come back another date for the separate problem/payer, or do totally separate notes as suggested. The provider is correct in wanting to do two separate encounters, they really should not be mixed.
 
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