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Modifier Needed?

  1. #1
    Greater Pittsburgh Chapter
    Default Modifier Needed?
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    One of our surgeons performed an I&D CPT 10060 with diagnosis 527.2 on a patient in the hospital. Patient was discharged and then four days after the initial procedure, presented again with a recurrence of the abscess.

    Another surgeon in our practice then performed CPT 21501 with diagnosis 682.1 four days after the initial procedure. Do I need to use modifier 78 or perhaps 79? Do these modifiers apply when another surgeon in the group performs the second procedure since we bill under the group NPI?

    Thank you,

  2. #2
    Milwaukee WI
    Default duplicate question?
    Didn't I just answer this question (or one very similar) a day or two ago?

    Physicians in the same practice and of the same specialty are considered the "same physician" for coding purposes.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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