Gastroenterology Coding Alert

Know when to go to modifiers 24 and 57 when you report E/M with certain hemorrhoid codes. You're familiar with the practice of appending modifier 25 when you report a significant and separately identifiable E/M service your physician provides on the same day as a procedure. But if your physician performs anal procedures, you should be aware of two other E/M modifiers to call on under certain circumstances. When your physician performs a significant and separately identifiable E/M service that falls within a procedure's 90-day global period -- a major procedure -- modifier 25 is not appropriate. You'll need to report modifier 24 or 57. Very few codes a gastroenterologist's office reports have 90-day global periods, so this won't be something you see every day. But you should understand it when the occasion arises or risk losing payment. Post-Op? Use Modifier 24 Sometimes, a physician examines a patient within the 90-day [...]