Wiki 2nd opinion by other surgeon in group

sheardmd

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I have a patient that had a lumpectomy. During her global period she decided to get a 2nd opinion from one of our other surgeons in the group. She didn't feel that she was getting appropriate care and wanted to discuss possible reconstruction options and we also scheduled her for a port-a-cath placement at the visit. The 2nd opinion was 1.5 hours. Would this be billable with the 24 modifier? Any other suggestions? Obviously surgeon B would like to be paid for this very long consultation.

Thanks,
Melissa
 
I can't see where a 24 is necessary. I do understand you're probably billing under the same tax id, but it is a different physcians name that will be on the claim. I would bill the consult with the new dx of the port of cath placement in which case would be a pre-op at that point. If it is any other payer than Medicare, I would kick it paper and attach notes to prevent claim delay.
 
I would bill your second opinion with modifier 24. Regardless of who the doctor is, the same tax ID can and will cause this to error out as global since you are in the same group if you bill without any modifier. You may want to attach the notes as well to show it's a 2nd opinion to avoid the appeal process. Many insurance companies are now switching to Medicare's global package so you may have a fight on your hands.
 
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