Modifier Coding Alert
Pick Modifier 24 with Unrelated E/M
PDF
Question: One of my physicians’ patients came into our office for a follow-up visit related to the removal of a lump (11604) near her knee that she had two weeks ago. The surgeon confirms the outgrowth to be a sarcoma of the bone (170-176, Malignant neoplasm of bone and articular cartilage). When the patient comes back in to the office for review, the surgeon does an extensive office visit with the patient to discuss the change in treatment. Do I need a modifier on the E/M service?
Minnesota Subscriber
Answer: If your physician expected the sarcoma outcome and the course of treatment doesn’t change, the visit would be a post-op 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).
If, however, the sarcoma was a potential outcome, not an expected outcome by your physician, and the treatment course is going in a different, more involved direction, you could code the visit with the appropriate level of service illustrated in the note with modifier 24 (Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period) attached to a new diagnosis.
Modifier Coding Alert
- Modifier Madness:
Curb Your Screening Denials Using Modifier 33
Some payers accept 33, while others won’t. If your practice sees patients for preventive services, [...] - ICD-10:
Have No Fear with Future Appendicitis Codes
The ‘other’ appendicitis codes are expanded and more precise. If coding appendicitis is commonplace for [...] - Modifier Partners:
Use GC to Recoup Resident Charges
You might get paid even when your physician is not with her resident performing services. [...] - Multi-Use Modifier:
Untangle Modifier 52 and 53 to Bring in Deserved Dollars
Never use modifier 53 when patient elects to stop the procedure. When your provider stops [...] - Reader Question:
Rely on Code Descriptors, Then Attach Modifier 50
Question: I have a physician who removed both the tube and ovary on one side and [...] - Reader Question:
Shelf Modifier GW When Not Hospice-Related
Question: My physician has an established 85-year-old patient who lives at home and has recently been [...] - Reader Question:
Be Sure There's One Practice with 77
Question: A patient came in this week to see our otolaryngologist. The doctor treated the patient [...] - Reader Question:
Pick Modifier 24 with Unrelated E/M
Question: One of my physicians’ patients came into our office for a follow-up visit related to [...] - You Be the Coder:
Modify Anesthesia Services From AA to QY
Question: When would you use modifiers AA, AD, QY, and QK? I don’t understand their purpose. [...]