Wiki 2 E/M same day-different docs

[stpat]

Our general cardiologist saw a patient today and then requested a consultation from our peripheral vascular/interventionalist cardiologist on the same day. I can see this as being possible if the interventionalist is listed under a separate taxonomy code but what modifier would I attach to the second E/M encounter? The 25 modifier says "same physician." Btw, this is a commercial insurance patient.

 

[dimmitta]

Are the two cardiologists listed under different tax codes or accredited as different subspecialties? There really isn't a modifier that can be applied for this purpose. If they have different tax numbers you would not need a modifier on the second E/M encounter.

Even if they are both under the same specialty/tax number you should still be able to, provided that it really was necessary for the interventionalist to see the patient. There is also the option of using a 57 modifier, provided the interventional cardiologist decides during the consult that there needs to be an intervention performed. This is a tricky situation, the worst that can happen is the consult is denied and you get paid nothing, which is what you'd get if you didn't bill anything at all