Wiki Can the Assistant Surgeon (MD, modifier 80) bill a consultation where decision for surgery was made? (modifier 57)

[cliff.chen89]

Can the Assistant Surgeon (MD, modifier 80) bill a consultation where decision for surgery was made? (modifier 57)

Provider A saw and performed a consultation on PT, where the decision for surgery was made. However, Provider A acted as the Assistant Surgeon and Provider B was the primary surgeon during the surgery.

Can Provider A (MD) who was the Assistant Surgeon (modifier 80) on the surgery still bill their consultation with modifier 57 (notes documents decision for surgery was made) even if they were not the primary surgeon?

 

[thomas7331]

Yes, there are no rules that say that the consultation has to be the same individual as the primary surgeon. Services are often shared between physicians and mid-level providers who work within the same specialty and cover for each other. It is not unusual to see this.

 

[cliff.chen89]

Thanks!