Wiki Same patient two different dr.

cdaniels36

Guest
Messages
3
Best answers
0
We had a 4 year old come in yesterday and say one dr in the morning. Had a allergic reaction to medication and then came back and saw another dr in the after noon. What Modifers would I use to separate the two visit?
Thank you Cathy
 
That would probably fit the -59 modifier description (distinct procedural service). The more specific modifier under that -59 umbrella would be XP (separate practitioner). You can use that modifier when a different practitioner in the same group NPI performs a second procedure in the same day.

Although in this situation if the 2nd procedure is related to the first, and it requires the use of an operating or procedure room then you would want to consider modifier 78 (unplanned return to the operating/procedure room)

Hope this helps!
 
Last edited:
We had a 4 year old come in yesterday and say one dr in the morning. Had a allergic reaction to medication and then came back and saw another dr in the after noon. What Modifers would I use to separate the two visit?
Thank you Cathy

Are the two providers in the same group and of the same specialty and did the second physician see the patient for the same reason? Also were any procedures/treatments done by either and if so what?

Sorry, just not enough information to provide an accurate response. If both are the same group/specialty and nothing different is done and/or the child's condition is not worsening, you probably won't be able to compliantly bill for both visits.
Sometimes you're going to have situations where you are not going to be able to get separate reimbursement and just count it up to good patient care.
 
Top