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Thread: 2 E/M Codes

  1. #1
    Join Date
    Apr 2007
    Roanoke, VA

    Default 2 E/M Codes

    AAPC: Back to School
    I need some guidelines for my Providers regarding billing 2 E/M services on the same dos. This issue seems to come up more often and I don't really think that it is appropriate. I would really like to be able to give them something in writing to address some issues. Any suggestions would be greatly appreciated. I need this as soon as possible.

  2. #2
    Join Date
    Apr 2007
    Columbus, OH


    It depends on the situation. Is the patient being seen twice by one doc or different docs; in different settings or the same; for different conditions? The answer is generally that two E/M aren't paid on the same day, but the reference and answer would depend on the situation.
    Amy Crego, CPC, CPC-P
    Treasurer, Columbus AAPC

    One can never consent to creep when one feels an impulse to soar. ~ Helen Keller

  3. #3
    Join Date
    Apr 2007
    San Diego



    In addition to the questions "acrego" posted, I know that two e/m's are appropriate to bill on the same dos when one is a "problem oriented" visit and the other is a preventative service. The cpt book actually tells you that this is allowed with the use of a -25 modifier and the instances in which this would be appropriate. Hope this helps!
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

  4. #4
    Join Date
    Apr 2007


    what is your email address? I would like to forwad you a copy of the 1995 and 1997 guidelines for E/M.

  5. #5
    Join Date
    Apr 2007
    Newport News Virginia

    Default 2 E/M Codes

    Preventive Medicine Services on the CPT book, Evaluation & Management section, provides instructions when to report 2 (two) E/M services, the appropriate modifier to be used and what the codes include. Some insurances will pay for both reported services, others might not. Remember to obtain an ABN for MCR patients, most preventive services ara a statutory exclusion from the MCR program. G0344 Initial preventive physical examination services limited to new beneficiary during the first six months of Medicare enrollment, would be covered and should not be billed with another Preventive E/M service (eg. 99397). This is commonly referred to "Split Bill".

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