decisionhealth Newsletters, Answer Books - 2011 Issue 4 (April)
Evaluation and Management Services / Two doctors, same practice, same day
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Article Overview
This article reviews guidance from the Medicare Claims Processing Manual on same-day evaluation and management services when more than one physician in the same group practice sees the same patient. It is aimed at coders, billers, and physician practices that need to understand how group practice and specialty rules affect reporting of E/M services. The article provides general billing guidance and references related evaluation and management topics.
Why This Topic Matters
Same-day E/M encounters can affect whether one or more services may be reported in a group practice setting, which is important for compliant claim submission and accurate physician billing.
Article Sections
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Medicare Claims Processing Manual guidance
Introduces the Medicare manual material relevant to same-day E/M services in group practice settings and frames the issue addressed by the article.
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Same-day E/M services in the same group practice
Discusses how multiple face-to-face E/M encounters by physicians in the same group are handled when the patient is seen on the same day.
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Example of multiple physicians seeing the same patient
Provides a broad illustration of how the article applies the manual guidance to a scenario involving more than one physician in the same practice.
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Related topics
Lists additional evaluation and management topics that are referenced for further reading.
What You Will Learn
- How Medicare group practice guidance addresses same-day E/M services
- What factors make same-day physician encounters relevant for billing review
- Which types of related E/M topics are connected to this guidance
- How practice specialty and grouping affect general E/M reporting considerations
Who Should Read This
- Medical coders
- Medical billers
- Physician practice administrators
- Compliance staff
- Revenue cycle professionals
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