Otolaryngology Coding Alert

Medicare will only allow return to OR with modifier 78.CPT rules allow you to report an E/M service with modifier 24 (Unrelated evaluation and management service by the same physician during a postoperative period) if the surgeon evaluates the patient for a complication during a previous procedure's global."Because payers following CPT guidelines do not consider postoperative complications as necessarily 'related' to the initial surgery, you can charge for an E/M service. However, you should use the 24 modifier to tell the payer that the E/M service is distinct and not a part of the global surgical package," says Marcella Bucknam, CPC, CCS-P, CPCH, CCS, CPC-P, COBGC, CCC, manager of compliance education for the University of Washington Physicians Compliance Program in Seattle.Diagnosis tip: When reporting a service with modifier 24, you should use an ICD-9 code that describes the new problem (for instance, post-op infection). Do not use the same diagnosis [...]