Marilyn Posted Fri 25th of March, 2011 02:21:18 AM
How do I bill when a patient is seen by the same physician at hospital "outpatient" then patient comes to clinic to see doctor same day?
SuperCoder Answered Mon 28th of March, 2011 04:21:12 AM
1st Option: If the Medical Necessity of the both the Visits are same, then we need to bill it once only with a higher level of E/M. Now, what will be the site of service here? It depends where the doctor provided higher level of service, and on that basis the doctor can bill.
2nd Option: If the Medical Necessity of both the visits are different, then we can bill it differently one on own NPI and the other on hospital APC. The second visit, i.e., to the doctor's office should be billed with modifier 25.
3rd Option: There may be an issue of reimbursement in case of Medicare in 2nd case, so it is always a better option to bill it once with a higher level of E/M based on combined documentation of service provided on both visits.