Medical Billing Modifier 56 Pitfall Using modifier 56 in a medical billing preoperative consult can be used by a specialist or even a primary care physician. Many people believe specialists are only allowed to perform consultations. This is incorrect thinking. If done correctly medical billing reimbursement is allowed for family care practice consultations. There are two main situations in which a family care physician would perform a consultation in medical billing. The first, and the most common scenario, is when a surgeon requests that a family practice physician examines their patient prior to surgery. They would do this to make sure the patient is healthy enough to undergo the specific …