AAPC - Back to school
Results 1 to 4 of 4

Thread: EP & Cardiologists in same ofc

  1. #1

    Cool EP & Cardiologists in same ofc

    AAPC: Back to School
    Please help!

    I thought I had this all figured out.... obviously not

    We have a group of cardiologists and we recently added an EP doctor. They all bill under the same tax ID#.

    If our cardiologists refer a patient to the EP doctor, is this considered a new patient? We are having a difference of opinions here.

    In the hospital, again, our cardiologist sees the patient, then the EP doctor or vice versa the EP does a procedure so the patient is now in a global period and the cardiologist sees the patient for a different dx.

    I am getting denials all over the place. Should I even spend the time to fight them? I was told the EP doctor was credentialed as an EP doctor, but the insurance companies don't seem to be seeing that way. Do I need to help them see the light (haha)

    I'm sure this isn't a new issue. I so appreciate any help/guidance!

  2. #2


    Since your cardiologists and EP specialist are all billing under the same tax ID a patient who is referred to the EP specialist by one of your cardiologists is considered an established patient.

  3. #3
    Join Date
    Apr 2007
    Jacksonville NC


    We have a cardiology office also, and our electrophysiologist joined us a couple of years ago. This is the first that I have heard of this - does anyone have a reference that I can go to to the information stating that if a Cardiologist refers to an EP doctor within the practice that the EP doctor can't charge as a new patient visit. Also the tax id number is the same for everyone in our group.

  4. #4


    I bill for a cardiologist and we have multi physician specialities under the same tax ID as long as they are different speciality under same tax ID you can bill as new patient. If you are getting denials from a specific payer I would call and explain these are two different speciality providers.

Similar Threads

  1. 93306 (Echo's) family practice vs. cardiologists
    By deeya in forum Billing/Reimbursement
    Replies: 1
    Last Post: 07-05-2011, 04:36 PM
  2. Cardiologists and EP in same office
    By heatheralayna in forum E/M
    Replies: 8
    Last Post: 01-19-2010, 02:14 PM
  3. Cath & Interv done by 2 separate Cardiologists
    By coding?4u in forum Cardiology
    Replies: 0
    Last Post: 12-31-2009, 10:41 AM
  4. Cardiologists and CMS rules
    By HCCCoder in forum Cardiology
    Replies: 3
    Last Post: 11-24-2008, 06:47 AM
  5. 2 cardiologists working together in the cath lab
    By KTOWNSEL in forum Cardiology
    Replies: 1
    Last Post: 08-19-2008, 12:33 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.