tci E/M Coding Alert - 2013 Issue 4

Reader Question: Ensure Unrelated Problem Before Coding 2 E/Ms on 1 Day

Question: Can we bill two office visits on the same day? We reported 99214 twice for the same date of service but used different diagnoses and insurance paid one and denied the other. Tennessee Subscriber Answer: It depends on what the diagnoses were, but most insurers will not allow you to report two E/M services on the same date. These payers base their regulations on Medicare rules, which prohibit you from billing these together. According to MLN Matters article MM4032, “Carriers MAY NOT pay two E/M office visits billed by a physician (or physician of the same specialty...

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