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E/M with modifier

  1. #11
    Default
    Exam Training Packages
    Then it sounds like 25 is the way to go it documentation supports it.

    Laura, CPC, CEMC

  2. #12
    Location
    Kachina Coders
    Posts
    53
    Smile
    Thank you so much for your patience and answering back. Sometimes it is hard to put down in words what it is your trying to say.
    Cynthia
    Mesa, AZ
    CPC

  3. #13
    Location
    Milwaukee WI
    Posts
    4,466
    Default Same group does NOT equal same specialty
    Cynthia,

    I don't want to further confuse you, but just because they are under the same Tax ID (i.e. the same group) does NOT mean they are of the same specialty.

    I work for a major medical center. We have HUNDREDS of doctors, all with the same tax ID (i.e. the same group). But we have dozens of different specialties.

    So if the hospitalist saw the patient in the morning, and the CV surgeon (different specialty) placed the central line in the afternoon no modifier would be needed for the hospitalist's services. Same group but DIFFERENT specialties, so they are NOT considered the same doctor.

    If the intensivist saw the patient in the morning and a different intensivist placed a central line later the same day, then you would need a -25 modifier on the FIRST physician's E/M code. Same specialty so they ARE considered the same doctor.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  4. #14
    Location
    Columbia, MO
    Posts
    12,557
    Default
    Yes I agree with Tessa, If they are two different specialties then usually you send 2 separate claims and there is no problem.

    Debra A. Mitchell, MSPH, CPC-H

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