modifier

cmac

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does anyone know, when a patient has a procedure (say an excision & they are in a 10 day global period) and they are seen for something else 8 days later that is not related to the excision, what modifier to use? Medicare is denying stating it needs a modifier, i tried 79 and that is not correct. Any suggestions???
 

cmac

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i don't think this applies b/c we are not an ambulatory sugical center we are a physician's office, thanks though
 

MISSI

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Use the 24 modifier if it an E/M code, I worked at Medicare for 16 years and you should use the 24 mod and your DX must indicate a different DX, and if you have a pt with a chronic condition, use that DX too, ASC has nothing to do with it.

the 79 is for only surgical codes anyway, hope this helps!!
 

relong

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if its an E&M code its a 24, but the diagnosis should be different from the global procedure... and hopefully your physician has documented correctly incase you have to sent records.
 
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