Two providers rounded same patient

Lisa Bledsoe

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Dr. A rounded in AM and asked Dr. B to f/u in PM on an inpatient. Dr. B ended up spending 45 minutes with patient and family, but Dr. A already put through his charges. Can Dr. B code anything?
 

mbort

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I am not an E/M expert by any means, but I think that if both docs are in the same practice, same tax id #, that they would only be allowed one E/M code per day otherwise it would deny out as a duplicate, unless of course Dr B saw the patient for something completely different than Dr A and you could modify the e/m. I'm interested in seeing how the E/M experts respond to this as well.
 
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Modifier 77?

This question is filed in the Pediatrics forum, so I'm assuming we're not talking about Medicare at all.

Modifier 77 would allow "repeat procedure by different physician on same date."

If the patient was critically ill and they were providing critical care, they could each bill 99291 as long as they had documented the time spent in critical care and each of them had at least 30 minutes. (Or Dr A might have had a subsequent visit and Dr B billed critical care due to patient's worsened condition.)

You might still get a denial, but you can appeal with the distinctly separate progress notes.

I'm curious as to why Dr A was so quick to submit charges when s/he knew s/he had asked colleague Dr B to also check on patient the same date.


F Tessa Bartels, CPC, CPC-E/M
 
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