JSimpson
Guest
When a patient returns to the office later in the day, see's a different physician for a different issue do I use the 59 or 77 modifier on the 2nd E/M CPT?-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Modifiers for 2 office visits same day
- Thread starter JSimpson
- Start date
When a patient returns to the office later in the day, see's a different physician for a different issue do I use the 59 or 77 modifier on the 2nd E/M CPT?Sabrina.
New
Modifiers for 2 ov same day
It is my understanding and our practice as mutli specialty providers that we would not use a modifier. The providers NPI's will reflect their specialties. A mod 77 states that the pt is seeing a different provider but for a repeat procedure and this would not be the case if a pt was coming in to see an allergist and then seeing infectious disease later in the day. A mod 59, again, is related to procedures and these are not procedures but E&M's. We do a bit of calling to ins co to have them correct the inproper dup denials but it is a clean claim with no modifier attached.
hope that helps
It is my understanding and our practice as mutli specialty providers that we would not use a modifier. The providers NPI's will reflect their specialties. A mod 77 states that the pt is seeing a different provider but for a repeat procedure and this would not be the case if a pt was coming in to see an allergist and then seeing infectious disease later in the day. A mod 59, again, is related to procedures and these are not procedures but E&M's. We do a bit of calling to ins co to have them correct the inproper dup denials but it is a clean claim with no modifier attached.
hope that helps
Lisa Bledsoe
True Blue
Different provider/different problem = modifier -25. (physicians in the same group practice of the same specialty are considered to be the same physician).
Herbie Lorona
Expert
Yes modifier 25 would be the correct one to use.
mitchellde
True Blue
25 is right, neither 59 nor 77 can be used with an E&M code.