Wiki In patient consult and I & D same day

[Denver Recon]

My doctor was asked to see an inpatient patient for consultation (Level 1) She ended up doing an I & D of a wound on the thigh. Patient has medicaid..can I bill the two together? Thinking 99221 & 10060..is there a modifier I should be using?

Thanks!
Carrie

 

[Naveen Rachagolla]

Add modifier 25 to 99221.

 

[MBA2]

If patient has Medicaid, you don't use modifier 25 on the E/M code...you need to use modifier AG on the I & D code.

example: 99221
10060-AG

Hope this helps.

 

[Naveen Rachagolla]

AG -Primary Physician - Surgical: Used to denote a primary surgeon. In the case of multiple primary surgeons, two or more surgeons can use modifier AG for the same patient on the same date of service if the procedures are performed independently and in different specialty areas. This does not include surgical teams or surgeons performing a single procedure requiring different
skills. An explanation of the clinical situation and operative reports by all surgeons involved must be included with the claim.