Medical Billing Forum
Coding => Coding => : mkarnes January 25, 2012, 11:55:17 AM
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One of our general cardiologists saw a patient today and then requested a consultation from our interventionalists/peripheral vascular cardiologist on the same day. If our interventionalist is listed under a separate taxonomy code, then the consultation should be allowed but what modifier would I attach to the consultation since it is on the same day as the initial E/M with the first cardiologist? Btw, this is a commercial insurance patient. :-\
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Shouldn't be a problem. The 2nd doctor will need to have the UPIN of the referring doctor on his claim. Both can have an E/M code on the same day, even if it's a new patient code.
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Thank you!!
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DMK, it sounds like they are billing using the same EIN/Group NPI. I don't think they will allow for two new patient codes from the same group on the same date. I've been out of things for a few days so maybe I'm missing something??
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Re-reading the initial post, I missed that! But if it WAS NOT the same group would both doctors get paid?
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I believe they would as long as it wasn't inpatient, but if they are in the same group (same NPI) they will not receive reimbursement for both
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The two doctors are under the same tax id number but have individual NPI numbers. This is in an outpatient setting.
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If they are in same practice and it's a group practice, no they won't get reimbursed for both.