Wiki 2 physicians different specialities billing under same tax id number

[cward267]

2 physicians different specialities billing under same tax id number - one phy billing hosp admit the other billing consult with a 25...is this the correct way to bill this? Surgery is going to be done by consult phy the next day.

Thanks

Carolyn S CPC

 

[Naveen Rachagolla]

I think in this scenario the admitting physician can bill 9922? and the consulting physician can bill consult codes with mod 57 as they planed to perform the surgery with proper documetation. The documentation should reflect the requesting physians informations and requested physicians information and it should be signed, and also it differes if the patient has medicare as medicare stopped paying consulting codes.

 

[Pam Warren]

Why would you need the -25? With the billing of two different specialities, this modifier is not necesary, unless your payer specifically requires it. We do not append the -25, and only occasionally do we ever have to appeal with notes. Bill the 9922x for the admitting, and the consult code with the -57 for the specialist. If it's a Medicare patient, bill 9922x for both, also with the -AI on the charge for the admitting.