Wiki Two E/M same dr different levels

[Sandra Fender]

I am having a problem and hoping and praying I get some responces on this as I have a huge problem

I work for a PCP office, we are now billing for a sleep study company, the company comes to the office and sets up the machine and the patient takes it home to use for 3 nights. Now according to there billing sheet I am to bill 99211 for this service. The 1st problem is if they see the Dr the same day I can not bill 99211 and 99214 (example), 2nd is patient is getting charged 2 copays or and deductables, even if they come in a different day, rep says some offices don't charge the copay some do, some upcode (wrong They also feel that I should be billing the day they return the machine vs the day they go over the set up and the face to face...My biggest problem is the two E/M codes....HELP please, I don't even think there is a modifer that would work

 

[mitchellde]

you cannot charge a 99211 for the company to do this, to charge a 99211 the person providing the service must under the employ of the physician. You cannot no charge a co pay when a visit is renderd and you cannot arbitrarily upcode. If the provider sees the patient twice then you add the complexities of both encounters and code only one visit, if the provider does not see the patient for visit number 1 there can be no charge generated by the office.

 

[Sandra Fender]

THANK YOU! Just comfirmed everything I was thinking.