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Thread: 2 Office Visits same clinic

  1. #1
    Join Date
    Apr 2007

    Default 2 Office Visits same clinic

    AAPC: Back to School
    I work in a clinic with ten providers and a patient came in yesterday morning to see one provider for a skin problem. Patient indicated weight issue problems and the provider referred patient to another provider in the clinic. Patient then made another appointment to see the other provider same day in the afternoon.

    Can I bill two separate visits - two separate dx codes, two different providers, same facility, if so does one need modifier -25?

    Any help would be appreciated. thanks. Karen

  2. #2
    Join Date
    Apr 2007
    North Carolina


    30.6.5 - Physicians in Group Practice

    Physicians in the same group practice who are in the same specialty must bill and be paid as though they were a single physician. If more than one evaluation and management (face-to-face) service is provided on the same day to the same patient by the same physician or more than one physician in the same specialty in the same group, only one evaluation and management service may be reported unless the evaluation and management services are for unrelated problems. Instead of billing separately, the physicians should select a level of service representative of the combined visits and submit the appropriate code for that level.

    Physicians in the same group practice but who are in different specialties may bill and be paid without regard to their membership in the same group.

    Last edited by RebeccaWoodward*; 05-29-2009 at 08:24 AM.

  3. #3
    Join Date
    Apr 2007


    Thank you I appreciate the help. Karen

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