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Two services, 2 doctors, same DOS

  1. Default Two services, 2 doctors, same DOS
    Medical Coding Books
    I believe I have the right answer to the following scenario, just need confirmation and or documentation. I have a Medicare patient that was seen by two different doctors on the same day. One doctor charged an E/M visit, while the other doctor charged an I& D. They belong to different gorups/ practices. My doctor charged an I& D in which he did not get paid. Billing is requesting review of this charge to get it paid. To my knowledge, I do not think we can get this paid, due to the patient seeing two differnt doctors on the same day. The doctor that charged the E/M, I am not sure if the DX is related or unrelated. I do not think that the Dx would have an impact on this particular scenario. Thanks for any help!

  2. #2
    You will need to appeal with notes. If it is different dx that by all means you should get paid, if the E&M physician referred the I&D to your physician, get that referral. Seeing (2) physician's are difficult, but whoever sent the last bill will need to appeal and show proof of your services.
    Kiana CPC, CPC-H, BCS-M, BCS-R

  3. #3
    Duluth, Minnesota
    I would put a .25 modifier on the one providers E/M visit due to the procedure done the same day by the other provider.
    Donna, CPC, CPC-H

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