AAPC - Back to school
Results 1 to 5 of 5

Thread: Billing during post op w/ modifier 24

  1. #1
    Join Date
    Apr 2007
    Minot ND

    Cool Billing during post op w/ modifier 24

    AAPC: Back to School
    I had a doc ask me yesterday about this scenario--

    Pt has glaucoma and is taking meds to control it. Pt needs cataract surgery so we stop that med as it can increase the chances of complications after cataract surgery. Then after surgery during the 90 day global period everything looks fine so we start up the medication again. At that visit the docs want to charge an office call with the modifier 24 as it's a different diagnosis-glaucoma. I said the starting and stopping of the med was related to the cataract surgery and during the global period so I thought we would not be able to charge an office visit.

    As the doc's disagree, I wanted further insight from other coders.
    Thanks in advance for your opinion.
    Last edited by ValerieR; 07-21-2009 at 12:16 PM.

  2. #2


    I agree with you it is related to the surgery

  3. #3
    Join Date
    Apr 2007


    I am really tempted to side with your doctor on this one. Depending on how it was documented, I think this could very easily qualify to billed with a 24.

    If the patient was there for a follow-up on the surgery and they decided she was stable and put her back on the glaucoma meds then that would be included in the surgery.

    On the other hand if the patient came in just for the glaucoma I think that could stand alone and outside of the global period.

    They are two completely separate issues, the problem is they are in the same organ. If this was a case of a family practice doctor that did an I&D and 2 days later saw the patient for an URI, there would be no question that this was not part of the global period.

    I think it all comes down to documentation and intent on this one.

    Laura, CPC

  4. #4
    Join Date
    Apr 2007
    Minot ND


    We had called them back for the re ck post op cat and decided at that visit that the pt was stable enough to restart the glaucoma med with risk of complications

  5. #5


    I say it is billable. Modifier -24 can be used to indicate the service is unrelated to the surgery or that the visit is for disease management.

    When leveling out the service, I would not "count" anything related to the post-op care rather just the documentation related to the patient's glaucoma.

    Lisi, CPC

Similar Threads

  1. Post op modifier
    By shruthi in forum Modifiers
    Replies: 6
    Last Post: 06-03-2012, 09:01 PM
  2. Need help with post op modifier
    By ulmer in forum Modifiers
    Replies: 2
    Last Post: 02-15-2012, 01:44 PM
  3. Post op Modifier??
    By Jckidder in forum Billing/Reimbursement
    Replies: 3
    Last Post: 11-30-2011, 09:59 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.