No More Consults

I was at your teleconference today and I have a question. Suppose that an orthopaedic doctor admits a patient for hip replacement that is elective. He asks my doc (an internist) to see the patient for medical management. I bill a 99222 as an initial visit. The admitting doctor is the ortho doc but the code he uses is a surgery code. Who puts the modifier for the admitting doctor. The ortho didn't use an E&M code.

Have we seen official info on the modifier?

I would not put the modifier on your doc- he did a "consult" and was not responsible for the H&P. I assume CMS will get no one billing for the "H&P" in this case.

No info on modifier yet

In your example, if the ortho had scheduled the surgery, then you are correct, no H&P would be billed by the ortho. If the ortho saw the patient in the ED, decided to do the surgery, then the ortho could bill with a 57 modifier and presumably, the modifier that CMS has yet to release.

Either way, if the patient is not on your service, don't add a modifier.