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Modifier needed when two DIFFERENT Docs see a patient?

  1. #1
    Location
    Jacksonville Fl
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    Default Modifier needed when two DIFFERENT Docs see a patient?
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    Is a modifier needed on an E/M code when two different physicians see a patient in the office on the same day?

    Both Drs saw the patient for different reasons in the same office each have their own office note documented to support their level.

  2. #2
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    This successful if both docs are a different specialty and no modifier is needed. If they are in the same specialty only one will be paid and no modifer will stop that from happening.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    North Carolina
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    30.6.5 - Physicians in Group Practice
    (Rev. 1, 10-01-03)

    Physicians in the same group practice who are in the same specialty must bill and be paid as though they were a single physician. If more than one evaluation and management (face-to-face) service is provided on the same day to the same patient by the same physician or more than one physician in the same specialty in the same group, only one evaluation and management service may be reported unless the evaluation and management services are for unrelated problems. Instead of billing separately, the physicians should select a level of service representative of the combined visits and submit the appropriate code for that level.

    Physicians in the same group practice but who are in different specialties may bill and be paid without regard to their membership in the same group

    http://www.cms.gov/manuals/downloads/clm104c12.pdf

  4. #4
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    Columbia, MO
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    Thanks Rebecca I was looking for the same section, you always find it faster!

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Location
    Jacksonville Fl
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    thanks so much! very helpful!

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