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Otolaryngology Coding Alert

Modifiers:

Do You Pick the Correct E/M Modifier Every Time? Find Out.

Published on Tue Feb 28, 2012

Hint: Assign 57, not 25, for E/M prior to major surgical procedure. Your surgeon performs an E/M service on the same date as a procedure, so you reach for modifier 25, right? Not so fast. Ask yourself two questions first. Question 1: Does the E/M Follow Another Service? When an E/M service occurs during a postoperative global period, but for reasons unrelated to the original procedure, you should append modifier 24 (Unrelated E/M service by the same physician during a postoperative period) to the appropriate E/M code. By appending modifier 24, you make the payer aware that the surgeon is seeing the patient for a new problem, and therefore the payer should not include the E/M in the global surgical package of the previous procedure, says Marvel J. Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, owner of MJH Consulting in Denver, Co. Remember: You cannot bill separately for related services [...]
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