Wiki Modifier 24

[schanderson]

My physician performed an ablation on the patient and it just so happened that the patient got sick and was admitted to the hospital. He saw the patient for neurological issues not pain in the back. Was told to appeal, which i did and was told that I should have applied the modifier 24 on the days that he was seen in the hospital. I am confused because from what I read it is supposed to be used for office visits. Has anyone else run across this issue and managed to get paid with modifier 24 on claims where the patient was seen in the hospital or possibly material that I have not seen. Confused and stumped. Thanks again!

 

[sls314]

My physician performed an ablation on the patient and it just so happened that the patient got sick and was admitted to the hospital. He saw the patient for neurological issues not pain in the back. Was told to appeal, which i did and was told that I should have applied the modifier 24 on the days that he was seen in the hospital. I am confused because from what I read it is supposed to be used for office visits. Has anyone else run across this issue and managed to get paid with modifier 24 on claims where the patient was seen in the hospital or possibly material that I have not seen. Confused and stumped. Thanks again!

Modifier 24 is to be used on Evaluation & Management codes, but it's not limited to POS 11.