Wiki Modifier 24?

[MedicalCoder432]

Patient had a TURP, which has a 90 day global period. They came back two months after surgery with severe urethral pain. Provider says it is persistent since TURP. But he also says unclear etiology and he recommends a cystoscopy in office for further evaluation. By saying the etiology of the pain is unclear, does that make this an unrelated E/M that should be billed with a modifier 24? Or should this visit be included in the global period?

 

[csperoni]

Patient had a TURP, which has a 90 day global period. They came back two months after surgery with severe urethral pain. Provider says it is persistent since TURP. But he also says unclear etiology and he recommends a cystoscopy in office for further evaluation. By saying the etiology of the pain is unclear, does that make this an unrelated E/M that should be billed with a modifier 24? Or should this visit be included in the global period?

In a scenario like this, the provider is best qualified to determine if this is a complication of the procedure. I would query the provider for clarification if it is not clear from documentation.