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Split billing two issues, same visit

  1. Default Split billing two issues, same visit
    Medical Coding Books
    If a patient presents for a follow up visit related to a work comp claim and during that visit mentions a new complaint that is clearly not related to the work comp matter, can the provider bill the work comp carrier and the health insurance carrier, each, for their respective portion of a single E/M visit? (The provider addresses, and dictates, each matter separately for this visit.) Is there any written policy/policies to be found on this matter?

    Thank you for any help you can give.

    Alisa
    Alisa, CPC

  2. #2
    Default
    Quote Originally Posted by Alisa Dinneen View Post
    If a patient presents for a follow up visit related to a work comp claim and during that visit mentions a new complaint that is clearly not related to the work comp matter, can the provider bill the work comp carrier and the health insurance carrier, each, for their respective portion of a single E/M visit? (The provider addresses, and dictates, each matter separately for this visit.) Is there any written policy/policies to be found on this matter?

    Thank you for any help you can give.

    Alisa
    Dont know about written policies but we have situations like this and we usually create another encounter and bill unrelated services to Commercial carrier.

  3. Default Caution
    You need to be cautious when billing MVA and WC not to include any personal information unrelated to the MVA and WC. Separate notes and separate billing is a must for billing mva/wc and other separate health care issues.

  4. Default
    It was my understanding that you can bill to the two separate carriers, but you really have to dicate two separate notes and the billing must stand alone for each note to determine the levels, you have to evaluate each note separately. We usually however, require the patient to have two separate office visits on two separate days to avoid confusion and it is also difficult to understand the separate documentation requirements.

  5. Default Thanks
    Thank you for your responses, they are very helpful!
    Alisa, CPC

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