Podiatry Coding & Billing Alert

Never append modifiers 55 and 56 to E/M codes.With four surgical modifiers to choose from, it's easy to get stumped when multiple DPMs take part in a global surgery package. If you overlook a modifier, however, you could end up short on reimbursement -- or, more likely, the subject of an audit for overpayment! Avoid surgical modifier missteps with this rundown.Check off 57 for Visits Prompting SurgeryDon't miss out on deserved payments by neglecting modifier 57 (Decision for surgery).Medicare says: The surgeon's initial consultation or evaluation of the problem to determine the need for surgery is a separately payable service not bundled into the CPT surgical code, states the Medicare Claims Processing Manual, Chapter 12, Section 40.1 (www.cms.gov/manuals/downloads/clm104c12.pdf).Note that this policy applies only to major surgical procedures (which typically have a 90-day global); the initial evaluation is always included in the allowance for a minor surgical procedure, the Medicare manual [...]