Wiki Okay to use -24 and -57 on same claim line?


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is it okay to use a -24 modifier and a -57 modifier on the same claim line? I have a decision for surgery visit on the same day as code 42962. But for the same patient one week prior, they had procedure 42821. The reason for the new visit/procedure is not the same as for the original service.
Okay - Yes / But may not be appropriate

Is it okay to use both -24 and -57 on one E/M service - yes.

Is it appropriate in your case - I don't think so. (Can't tell for sure without seeing all the notes.)

You cannot claim that a post-operative hemorrhage is not related to the original surgery. It is, in fact, clearly a complication of that original surgery. If the patient is covered by Medicare (and many other carriers), no post-operative visit - even for complications of surgery - can be separately coded.

I would not code the E/M service at all, but only code the 42962 with a -78 modifier.

Hope that helps.

F Tessa Bartels, CPC, CEMC
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