ER Visit 2 differents Physicians same Date

hellitz

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Local Chapter Officer
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Hi, I have two different physicians seen the same patient. Doctor A received and evaluate the patient in the ER at 1:42 pm the she left and the other physician continue with the care of the patient and discharge at 8:56pm both physicians can bill for her's service 99281-22985 ?
 

TThivierge

Expert
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Lithonia, GA
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ER Visit with 2 doctors same date same patient

Hi

In the past I have billed& coded ER visits. However, if both ER docs treated patient I would process the claims let the insurance company decide to pay or not, put a modifier 25 on one of the claims though.And if the patient was seen let us say at ER then later at clinic on same date, put modifier 27 on one of visits. But the insurance will probably deny if same DOS and same dx problem by both docs. However if differ dx problems on same date, by 2 ER docs at differ times but same date, the insurance probably pay both claims. However let us say the ER patient came in 2 different times on same date for 2 differ diagnostic problems these can be paid. Ahh hope this is clear for you.

Have a FANTASTIC day!

Lady T.
 

shellysk8

Networker
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Milwaukee, WI
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Clarification Requested

Hi,

I am not sure if you are saying Dr. A left and Dr. B continued the care? If the Dr. left then you can only bill one visit. If the patient left, and then returned and was treated by Dr. B, then you can bill both visits, with a 25 modifier on the second visit.

I hope this helps!

Shelly L. Kubacki, BS, MPA, CPC, CPMA
 
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