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Which doc gets the credit?

  1. #1
    Madison, WI
    Exclamation Which doc gets the credit?
    Medical Coding Books
    We have a patient that came in the office and saw a physician in the AM, then came back to Urgent Care and saw a second physician(same group) for the same complaint later in the day. I realize we can only bill one visit for that day, but which physician should get the credit?

  2. #2
    Covington, LA
    That will be an administrative decision. Was the disposition the same? Did one physician perform more work then the other?

  3. #3
    Milwaukee WI
    Default Our office protocol
    You should have an office protocol in place to deal with these situations.

    In our office, the first provider gets the entire credit every time. Over the course of time, it evens out.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  4. Default
    I agree with FTessaBartels, a standard office protocol is needed for these situations. I also agree that the first provider would get the entire credit, regardless of additional work being performed by the second provider.

    I would think of it as PM Provider bundles into the visit of AM Provider just like a procedure may bundle into another. You can't choose which procedure you want to bill based on reimbursement, you would have to bill the procedure that is considered 'primary'. In this case that would be the visit performed by the AM Provider.

    This probably only made things more confusing, and I am sure this can be explained better. But I hope this helps!
    Tracey Thompson, CPC, CPPM

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