Wiki Taxonomy codes

[vicki@chicagocardiology.com]

Cardiology practice with general cardiology and electrophysiology. Can two doctors from the same Cardiology practice see a patient in the hospital and bill? i.e. general cardiology condition (chest pain, etc.) which warrants exam by Cardiologist and electrophysiology conditons (pacemaker, afib, etc) warrants and exam by the Electrophysiologist. Both have two difference taxonomy codes but work in the same practice.

 

[thomas7331]

It will depend on how the payer defines the provider's specialty. Medicare, for example, does not designate specialty by taxonomy code, but by the specialty that is chosen by the provider on the enrollment form. In cases such as this, if the patient sees both providers on the same day, you're likely to get denials, but if your documentation is good and supports the need for both services and you can demonstrate that the providers have different subspecialties, you may be able to appeal and have some success getting payment.