Wiki packing follow up different providers

cnramsey

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Hello,

How are you guys coding ie. 10661 when the I&D is done by Dr A and than follows up the next day for packing with Dr. B. All providers are MD's and work in the same RHC Family Clinic. Dr. B did the next day repack due to Dr. A not working the next day. Since we are an RHC we would code this visit like this.

Dr. A 10061
Dr. B 99212-99213 to roll up to an Encouter rate for our RHC status and Dr. B will not receive any RVU's for the repacking.

My concern is shouldn't Dr. B be getting something for their time. Otherwise Dr. A receives all the the RVU's for 10061. I thought about coding 99212-99213 with modifier 55. But that wouldn't work since it says to put this on the procedure and not an E/M.

Thank you,
Nichole
 
The 54 & 55 modifiers are for use when there is a post-operative transfer of care to another provider, in which case both providers would bill these modifiers on the surgical codes, not the E&M codes. These modifiers are not normally used when the providers are of the same specialty and both part of the same group.

Unless your organization has directed you on how to separate out revenue between your providers, I wouldn't worry about trying to accounting for providers' time at this level of detail - this isn't really a coders' responsibility. Providers routinely cover for each other within a practice and it will likely average out over time. If the practice wishes, for compensation purposes, to account for every case where this happens, it can be better done through some kind of internal tracking in your system without having to split up coding for services on bills and involve the payers in something that really should just be between your physicians to work out. Just my thoughts.
 
The 54 & 55 modifiers are for use when there is a post-operative transfer of care to another provider, in which case both providers would bill these modifiers on the surgical codes, not the E&M codes. These modifiers are not normally used when the providers are of the same specialty and both part of the same group.

Unless your organization has directed you on how to separate out revenue between your providers, I wouldn't worry about trying to accounting for providers' time at this level of detail - this isn't really a coders' responsibility. Providers routinely cover for each other within a practice and it will likely average out over time. If the practice wishes, for compensation purposes, to account for every case where this happens, it can be better done through some kind of internal tracking in your system without having to split up coding for services on bills and involve the payers in something that really should just be between your physicians to work out. Just my thoughts.
Thank you!
 
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