tci Medicare Compliance & Reimbursement - 2017 Issue 5

Know the Concurrent Care Rules for Billing Subsequent Hospital Services

MACs focus on diagnosis and specialty to differentiate concurrent care. If you perform an E/M service for a patient on the same day as another physician, be certain that your claim is valid, medically necessary, and specialty specific or you run the risk of a denied claim. Nuts and bolts: Concurrent care occurs when two physicians perform separate E/Ms on the same patient on the same date of service. If the patient’s condition warrants the care of two (or more) physicians, you’ll both be able to code for individual E/Ms based on encounter notes. There are several...

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