I have a physician that tends to perform a preventive visit one day and then have the patient to return another day to perform an Echo. The Echo is billed out as diagnostic and then the patient usually has a higher out-of-pocket expense. But, the patient was informed that it was a part of their preventive visit. I would think, if this procedure was to be a part of the preventive visit, it should be billed the same day. Could someone clarify this for me? Is is appropriate to bill two separate days and if so, do you bill the dx V70.0 for the procedure and then a E/M code?