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What modifer should I use when billing an O.V. code one day prior to surgery?

Marina Posted Tue 09th of December, 2014 14:51:21 PM

I billed code 92012 one day prior to surgery using a modifier 24. Medicare denied stating this code was bundling with surgery code 66984. When I phoned into Medicare they stated a different modifier should be used for payment approval. What Modifier should I have used?

SuperCoder Answered Tue 09th of December, 2014 18:38:09 PM

Thank you for your question.

Modifer 24 is used during the POST operative period, therefore Medicare is bundling it into 66984. Your question is asking about 92012 in the PRE op period.
If the decision for surgery was made during that pre operative visit then Modifier 57 would be appropriate.

Modifier 24-Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period

Modifier 57-Decision for Surgery

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