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Office Visit

Marilyn Posted Tue 03rd of September, 2013 19:43:49 PM

Patient seen for "initial" and came back same day and Dr coding second visit "est" patient. Is this ok?

SuperCoder Answered Wed 04th of September, 2013 03:44:09 AM

No, codes 99201-99215 / 99221-99233 can be billed only ONCE PER DAY, for a patient. If there are multiple visits on same day, then you need to combine documentation of both services (both visits) and calculate the points accordingly and then create a single claim. Also, because the Pt. is "new" (or "initial" visit), this will be the Pt. status for this day's claim (since you need to combine points from both visits).

When this Pt. comes on another day, then s(he) becomes an Est. Pt. (apply new/est. Pt. rule).

SuperCoder Answered Wed 04th of September, 2013 03:47:43 AM

As long as any other physician of the same specialty and same sub-specialty sees the Pt. on same day (after 1st visit in morning by another physician), you need to follow the same rule mentioned above (combine visits -so that a single claim can go against a single doctor only). If physicians are from different specialties, only then you can bill separate visits on same day (that too, claim should be submitted with documentations supporting 2 separate doctors, from separate specialties, performing separate services). Else the 2nd visit claim is going to be rejected by insurances.

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