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2 e/m, 2 dr, 2 spec, same dx?????

  1. #1
    Columbus, OH
    Question 2 e/m, 2 dr, 2 spec, same dx?????
    Clearnace Sale
    We're a multi specialty practice and we had a patient see 2 doctors of different specialties on the same day. Both billed a 99213. The Orthopedic surgeron billed with dxs 721.0 & 723.4 and the Physical Medicine doc billed dx 722.81 & 721.0. So they saw the pt for the same issue in the same day.

    Can I bill these separately since they are different specialties or do I need to put the 2 E/Ms together and bill accordingly? If I bill separately, do I add a modifier 25 to one to get both paid? I had one paid and the other denied as a dupl.



  2. #2
    Greater Pittsburgh
    You can only bill for one E/M code for same date of service for the senario you listed. What are their separate specialties? The only orthopaedic Drs. that are considered separate specialties are UPPER EXTREMITITEY Drs, so if your spine Dr. did an office visit for the spine,etc.....than the upper extremity Dr. saw the patient for upper extrem.problem that was not related to the cervical spine problem (phanlanx fracture, carpal tunnel, etc...) then you could bill for each.
    Last edited by jdemar; 03-17-2010 at 09:02 AM.
    jdemar, CPC, CMA

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