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Orthopedic Coding Alert

3 Questions Clear Up Your Modifier 24, 25, 57 Confusion

Published on Sat Aug 01, 2009

Applying the correct E/M modifier can boost your bottom line by $100. To avoid denials for an E/M service on the same day as (or during the global period of) a procedure, try this foolproof method for choosing between 24, 25, and 57. Subscriber Anita Odum, coding specialist for Blue Ridge Orthopedic and Sports Medicine in Abingdon, Va.,e-mailed the Orthopedic Coding Alert editor and asked: "Our doctor saw a patient for an E/M service in the office and is going to perform a [related, major] surgery that evening or the next day. What modifier should I attach to the E/M service?" Ask yourself these questions to eliminate the bad choices and select the modifier that will provide the carrier with an accurate picture of the E/M service. Question 1: Does the E/M Follow Another Service? Answer: No. In the subscriber's situation, the E/M service happens prior to the surgery. Therefore, [...]
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