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Orthopedic Coding Alert

Modifier How-to:

Part 2: Modifier Mythbuster -- Learn the Truth Behind 3 More Common Modifier 24 Myths

Hint: Know your payer's policies on billing complication treatment.To ensure payment for E/M services your physician performs within the global period of a surgical procedure, you must know the ins and outs of modifier 24 (Unrelated evaluation and management service by the same physician during a postoperative period).Last month, we busted the first two myths: Modifier 24 applies to any service done in the post-op period and scheduled office visits rule out modifier 24. In Part 2, we'll tackle three more modifier 24 myths to ensure you're submitting clean, successful claims.Myth #3: You Can Never Use Modifier 24 For Complication-Related ServicesWhen you report postoperative services to payers that follow CPT® guidelines, you'll need to append modifier 24 to the E/M code to indicate that the service took place during the surgery's global period.Example: If a patient has abdominal surgery and returns to your office with a postoperative wound infection along [...]


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