# Modifier 56 and Referrals



## CGephart (Jul 20, 2011)

If a patient comes to your office for a pre-op exam and your not part of the surgeon's group, can you use modifier 56?  If yes, do you need a referral?


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## Jewel Mccray (Jul 20, 2011)

yes the modifier 56 can be used and you don't need a referral


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## FTessaBartels (Jul 27, 2011)

*No referral needed, but you DO need the CPT*

You don't need a referral, but you will need to know what primary CPT the surgeon will be using for the surgery.  You code THAT CPT with the -56 modifier. The surgeon will use a -54 modifier. The payer will split the "global fee" accordingly between the two physicians.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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