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Otolaryngology Coding Alert

Reader Question:

Use Modifiers In This Turb-Post-Op OV Scenario

Question: A patient who is returning for follow-up after unilateral endoscopic maxillary antrostomy with tissue removal and turbinectomy complains of a cough and fever. The otolaryngologist evaluates and manages the problem and also performs endoscopic sinus debridement on the patient. What modifiers do I need to report the encounter?Kentucky SubscriberAnswer: Because the unrelated office visit and a staged debridement (planned staging for the endoscopic maxillary antrostomy) occurred during the turbinectomy's 90-day global period, you will need to use modifiers 24 (Unrelated evaluation and management service by the same physician during a postoperative period) with the EM service and modifier 58 (Staged or related procedure or service by the same physician during the postoperative period) with the debridement. To indicate the E/M is a significant and separate service from the debridement, you will also use modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same [...]