Wiki Multiple Tests Same Day

[LindseyModica]

I work for a privately owned Cardiology office, my physicians prefer to schedule the patients who need multiple tests on the same day so the patient doesn't have to come back to the office multiple times. From what I have learned over the years is that Medicare does not want us billing multiple test on the same date of service. I'm looking for something in writing to show my Doctors that Medicare frowns upon this. If you need an example think of a patient coming for an echo, carotid Doppler, and venous Doppler on the same day, all medically necessary. I have googled and searched, I cannot find what I am looking for.

 

[AmandaBriggs]

I haven't seen any CMS guidance that states this. Our cardiology clinic does multiples tests on patients on the same date of service frequently. The only time we have issues is with patients having a nuclear stress test and other imaging modalities on the same day. The nuclear testing is always scheduled last so as not to expose the other techs to radiation. We use modifier 59 or one of the X modifiers for these services. Our coders also ensure that the diagnosis codes support the medical necessity and/or findings on each individual test.

 

[LindseyModica]

Awesome! Thank you! I was confused on why we were told to do that, but its what I was taught on the job by elder coders. This is great news!

 

[CodingKing]

The only problem CMS has with how multiple procedures are scheduled is when they are split up into different dates in order to get around edits

NCCI Manual Chapter 1

Physicians shall not inconvenience beneficiaries nor increase risks to beneficiaries by performing services on different dates of service to avoid MUE or NCCI PTP edits.