# Hospitalist and Modifier 25



## katcoder (Apr 29, 2013)

My hospitalist and general surgeon are in same practice but have different specialties.  On the same day the general surgeon performs surgery, my hospitalist does a consult on the patient for hypertension, diabetes, and hypokalemia….then sees the patient two more times during his in-patient stay.  I know I don't need a modifier on 99232, but wouldn't I put a modifier 25 on the 99253? 

99253/25	IP Consultation 
99232	Subsequent Visit
99232	Subsequent Visit

Thanks everyone for your help!!


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## CBaer (May 2, 2013)

*Hospitalist*



katcoder said:


> My hospitalist and general surgeon are in same practice but have different specialties.  On the same day the general surgeon performs surgery, my hospitalist does a consult on the patient for hypertension, diabetes, and hypokalemia….then sees the patient two more times during his in-patient stay.  I know I don't need a modifier on 99232, but wouldn't I put a modifier 25 on the 99253?
> 
> 99253/25	IP Consultation
> 99232	Subsequent Visit
> ...



No, if they are different specialties no modifier is needed.  However, if the hospitalist is an NPP and you recieve a denial from Medicare this would be because Medicare does not link a specialty to the NPPs.  You will need to show that the NPP is working in a different specialty.  This can be done by appealing and submitting documentation that shows that the NPP is working as an Internal Medicine or General Medicine and/or who the NPP supervising physician is and his/her specialty.

Modifier 25 would be used only if the hospitalist performed an EM and another service or a minor procedure (10 global days or less) on the sameday.


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## katcoder (May 7, 2013)

Thanks!


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