JChandraker
New
If 2 providers from different specialty within the same group performed 99291, will modifier be needed . If needed, then what modifier. Will both be paid?
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Wiki Code 99291
- Thread starter JChandraker
- Start date
TThivierge
True Blue
Hi
CPT 99291 is critical care for 30 to 74 minutes. If in same med specialty not both providers will be paid. Only one doctor is paid. However if working in same hospital then surgery treatment I'd add dx 62 on 2nd surgeon. However, I hope they document it is critical care and minutes performed on the record. Was it more than 74 minutes?
Anyway modifier 62 is for surgery setting with 2 surgeons and modifier 76 and 77 cannot use with any Eva/mgnt CPT codes. Was one a teaching physician learning by an attending doc who was there? Modifier GC defines that situation. Well, just bill the first doc got his note in on time, first come first serve.
I hope this data helps
Lady T
CPT 99291 is critical care for 30 to 74 minutes. If in same med specialty not both providers will be paid. Only one doctor is paid. However if working in same hospital then surgery treatment I'd add dx 62 on 2nd surgeon. However, I hope they document it is critical care and minutes performed on the record. Was it more than 74 minutes?
Anyway modifier 62 is for surgery setting with 2 surgeons and modifier 76 and 77 cannot use with any Eva/mgnt CPT codes. Was one a teaching physician learning by an attending doc who was there? Modifier GC defines that situation. Well, just bill the first doc got his note in on time, first come first serve.
I hope this data helps
Lady T
ccollison
Networker
Both providers could be paid if their documentation is adequate. Their medical specialty codes are different even though they have the same tax id #. Individual times must be documented and the medical necessity for both providers to be involved. No modifier should be needed. Do not combine their time.
C Collison, CPC, CCC, CPMA, CPPM
C Collison, CPC, CCC, CPMA, CPPM