In Coding
Aug 8th, 2018
Typical post-operative care, including related evaluation and management is not separately reportable; but, an unrelated evaluation and management service during a postoperative period may be. According to the Centers for Medicare and Medicaid Services (CMS), an E/M service provided during the global period of a procedure is unrelated if: • The E/M service is for ...
Payer rules differ with what’s considered an unrelated E/M service provided during the global period of a procedure. Typically, an evaluation and management (E/M) service provided during the global period of a procedure is not separately reimbursed, but is bundled into payment for the procedure. An exception occurs when the E/M service is unrelated to ...
In Coding
Jun 21st, 2016
Question: If an ob/gyn sees an established, pregnant patient during the antepartum for a problem unrelated to pregnancy, can the provider bill separately for that visit, or is the service bundled into the maternity care? If the provider can bill, is it necessary to append modifier 24 Unrelated evaluation and management service by the same ...
In Billing
Jun 15th, 2015
by John Verhovshek, MA, CPC To append modifier 25 with confidence, your claim must meet four criteria. 1. The same provider must provide an E/M service and another procedure or separate for the same patient on the same day. All providers who bill under the same National Provider Number (such as those physicians who share ...
In Billing
Mar 19th, 2015
Modifier 24 Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period shows that the E/M being billed is not part of the global surgical package and therefore is separately reimbursable. To further indicate that the procedure is unrelated, it is recommended to assign a diagnosis ...