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Office Visit

Vijay Posted Fri 20th of January, 2012 18:23:18 PM

Hi Sanjit,
Can we bill 2 office visit on same Day? i came with a query were i found CPT99214 billed twice in same day with different diagnosis and insurance paid one and other denied, could you please help me on this if we can use modifier or this would be provider's write off.

Thanks & Regards
Vinayak
wideangleoutsourcing

SuperCoder Answered Mon 23rd of January, 2012 17:27:26 PM

Paragraph B of Chapter 12, Section 30.6.7, clarifies “physician in a group practice” for office/outpatient E/M Visits provided on the same day for unrelated problems as follows:
As for all other E/M services except where specifically noted, carriers MAY NOT pay two E/M office visits billed by a physician (or physician of the same specialty from the same group practice) for the same beneficiary on the same day unless the physician documents that the visits were for unrelated problems in the office or outpatient setting which could not be provided during the same encounter (e.g., office visit for blood pressure medication evaluation, followed five hours later by a visit for evaluation of leg pain following an accident).

Ref:
https://www.cms.gov/mlnmattersarticles/downloads/MM4032.pdf
NOTE
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Non-Medicare payers can make their own payment guidelines. It is always safe to be aware of payer specific guidelines on this and make your physician aware of this.

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