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Thread: E/M same specialty,different dx

  1. #1
    Join Date
    Apr 2007

    Question E/M same specialty,different dx

    AAPC: Back to School
    I am in a multi-specialty office and we have several Neurologist. If Dr A, sees
    a patient with neck pain and bills an initial visit, then Dr B sees the same patient a year later with back pain, would this senario fall into the 3 year rule? Would I bill an established patient visit? I say yes, because both Dr's have access to the medical records and bill under the same tax ID#.

    Please help

  2. #2
    Join Date
    Apr 2007
    Greeley, Colorado


    Yes, this falls into the 3 year rule. Same specialty/same practice is considered to be the "same physician". Unless the patient is sent for a consultation, which you could code as long as documentation requirements for a consult are met and the patient is not Medicare.
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Join Date
    Apr 2007
    Athens, Ga.


    Walker Bachman, CPC, CPPM

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