Description
Repeat procedure by another physician.

Guidelines/Instructions
  • Submit this modifier to indicate that a basic procedure or service performed by another physician had to be repeated
  • This modifier may be submitted with EKG interpretations or X-rays that require a second interpretation by another physician. Palmetto GBA will reimburse a second interpretation of the same EKG or X-ray only under unusual circumstances, such as a questionable finding for which the physician performing the initial interpretation believes another physician's expertise is needed or a changed diagnosis resulting from a second interpretation of the results of the procedure. Absent these circumstances, Palmetto GBA may reimburse only the interpretation and report that directly contributed to the diagnosis and treatment of the individual patient.
Reference

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department



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