Ask Dr. Z

I have a two-part question regarding the use of the -25 or -57 modifier. We have cardiologists, interventional cardiologists, and electrophysiologists in our group. It is not uncommon for a patient to have an appointment with one of the cardiologists, and end up getting scheduled for a procedure by either the IC or EP doctors. Typically, the cardiologist and the IC or EP physician will discuss the case, and then schedule the patient for the procedure, without a separate appointment with the IC or EP. Question 1: If the procedure is planned, can the IC or EP bill for a visit on the date of the procedure/surgery? Technically, this will be the first time the patient is seen and examined by the IC or EP, and the final decision to proceed with surgery is made. Question 2: If so, can they bill a consultation (non-Medicare), or are they required to bill as the admitting/attending provider?