Wiki CPT for unrelated e&m visit

[lsmft]

How do I find a cpt code for a complaint voiced by patient during post op global period visit. I know there is the modifier 24 but what else?

 

[RebeccaWoodward*]

Are you speaking of the normal E/M codes (99211-99215)? If the visit was unrelated to the global period...you're correct....you would need to use modifer 24 with the appropriate E/M level. The appropriate E/M level will be determined by your providers documentation. Also...you want to use the diagnosis code that corresponds with this unrelated E/M service.

 

[lsmft]

I don't have the record but this was a post operative ortho surgical patient who had one of those "oh by the way, since I am here..." complaints.

While I am asking...are the global period E&M codes the same as the 99211-99215 codes?

 

[RebeccaWoodward*]

If the visit is related to the global period....99024

 

[lsmft]

thank you so much!!

 

[FTessaBartels]

99024 is for a global post op visit

99024 is the code for a global post-op visit.

Any other E/M service UNRELATED to the surgery is reported using the appropriate E/M code (depends on whether it's in the office, in the hospital, in the ER, etc) with the modifier 24 appended.

For example: Patient has knee replacement on 7-03-09. Patient comes to orthopaedic surgeon's office for post op follow-up visit on 07-15-09 and says "oh, by the way ... My left shoulder is really sore" Doctor evaluates shoulder. He would use a 99211-99215 code (established office visit) with a -24 modifier for the services related to evaluating the shoulder (and use only the shoulder dx codes for this)

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[lsmft]

thanks, i wondered if another em code would be appropriate. so let me clarify...i can use the global code AND another em code with a modifier?

 

[RebeccaWoodward*]

If appropriate...yes

Tessa provided a great example....

Here's another...

Pt is in global period for fractured arm.....

Pt returns to office for f/u....99024 and assign the fx diagnosis
During the visit...the patient complains of abdominal pain.....this would be assigned as 99213-24 and 789.0* (example only)

 

[lsmft]

thank you so much! it makes sense now.