Wiki Rehab Coding for Outpatient hospital services and billing


Chatham, IL
Best answers

Does anyone know about how to bill and code for a patient that is seen in the outpatient hospital setting and they have 2 different accounts with different diagnosis and the physical therapist treats both diagnosis on the same date? My boss states that it is ok to code 97110-therapeutic exercises- twice on the same dos because the patient has two different diagnosis and two different accounts? I disagree because per CPT 97110 says " for one or more areas" so wouldnt we just billl out 97110 x however many units with both the diagnosis on the claim on one account? and the other account would not have a charge on it? I am very confused and dont want to undermine the authority of my boss but per the CPT coding guidelines and the fact that ins companies do not go by what account the charges are on from a hospital stand point. Ins co just look at the fact that the same CPT code is done on the same dos. RIght? My boss says its ok because of the different dx and different accounts and that are billing office just needs to appeal the denial. I just disagree and would like some feedback from other people who have more coding and billing experience than me.