Two services, 2 doctors, same DOS

Trendale

Guru
Messages
230
Best answers
0
Hi,
I believe I have the right answer to the following scenario, just need confirmation and or documentation. I have a Medicare patient that was seen by two different doctors on the same day. One doctor charged an E/M visit, while the other doctor charged an I& D. They belong to different gorups/ practices. My doctor charged an I& D in which he did not get paid. Billing is requesting review of this charge to get it paid. To my knowledge, I do not think we can get this paid, due to the patient seeing two differnt doctors on the same day. The doctor that charged the E/M, I am not sure if the DX is related or unrelated. I do not think that the Dx would have an impact on this particular scenario. Thanks for any help!:)
 

Kiana

Networker
Messages
94
Location
Tucson
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0
You will need to appeal with notes. If it is different dx that by all means you should get paid, if the E&M physician referred the I&D to your physician, get that referral. Seeing (2) physician's are difficult, but whoever sent the last bill will need to appeal and show proof of your services.
 

dmaec

True Blue
Messages
1,133
Location
Duluth, Minnesota
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0
I would put a .25 modifier on the one providers E/M visit due to the procedure done the same day by the other provider.
 
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