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Post operative vs a 24 modifier

Laurie Posted Thu 14th of February, 2019 10:58:22 AM
patient comes in to office see's the doctor for a follow up to the surgery in the global days., but he also comes in for a new problem can we charge for the office visit with a 24 modifier?
SuperCoder Answered Fri 15th of February, 2019 01:34:09 AM

Thank you for your Question!

Modifier 24 is defined as an unrelated evaluation and management service by the same physician or other qualified health care professional during a post-operative period.

 

Use Modifier 24 with the appropriate level of E/M service.

 

Modifier 24 on an E/M would be appended when an unrelated E/M service is performed beginning the day after the procedure, by the same physician, during the 10 or 90-day post-operative period and documentation indicates the service was exclusively for treatment of the underlying condition and not for post-operative care.

 

Note: The same diagnosis as the original procedure could be used for the new E/M if the problem occurs at a different anatomical site.

 

Do not use Modifier 24 for undermentioned scenarios:

  • when the E/M is for a surgical complication or infection. This treatment is part of the surgery package.
  • The service is removal of sutures or other wound treatment. This treatment is part of the surgery package.
  • The surgeon admits a patient to a skilled nursing facility for a condition related to the surgery.
  • The medical record documentation clearly indicates the E/M is related to the surgery.

Hope this Helps! 

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