Wiki Different Docs in Post-Op

[chrissylyman0629@gmail.com]

What modifier would work for this situation?

Patient had procedure 67228 performed by physician X and is the post-operative period and receives and injection 67028 for the same eye for same diagnosis, however physician Y performs the injection.

Physician X and Y are in the same specialty.

 

[annawade13]

I believe the actual provider is irrelevant in the selection of codes/modifiers in this case. You would code it just the same as if the original provider were providing the care. If 67028 isn't billable by the original provider, it isn't billable by a provider in the same specialty and practice. If it is billable by the original provider, you can bill it.

Since 67028 is not a part of the global package, I think I would bill it with either a -58 or -79 modifier depending on if it were related or unrelated to the original procedure.

Hope this helps!

Anna