Kathy Posted Mon 18th of January, 2016 12:24:38 PM
If a provider sees a patient within the global period of a surgery that will required a lot of treatment (eg. chemo, radiation, etc.)and the provider spends most of the time counseling the patient about these upcoming & other potential services, is there any way the provider may appropriately bill for this E&M visit? Thanks.
SuperCoder Answered Tue 19th of January, 2016 08:32:55 AM
Thank you for your question.
You should first determine how the office visit (99212-99215, Office or other outpatient visit for the evaluation and management of an established patient ...) relates to the operation.
If the visit relates to the surgery, and the operation's global period is still effective, you shouldn't charge for the postoperative E/M service. To track the visit, you may enter 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason[s] related to the original procedure) at a zero-dollar value.
Also, in a scenario where the E/M service during the global period is unrelated to the surgery, append Modifier 24 (unrelated evaluation and management service by the same physician or other qualified health care professional during the postoperative period) to indicate the same. Modifier 24 is only used when the original procedure had a 10- or 90-day global period. There would be no reason to use it for an E/M service after a procedure with zero global days because no postoperative services are valued into these procedures.