The -78 modifier will go on the surgery.
The office visit at which the problem was identified ...
Medicare (or T-19) just won't pay for any office visits in the postoperative period unless it is COMPLETELY unrelated to the original surgery. So you'll be using 99024 for the postop follow-up with no charge.
Some commercial payers MIGHT accept an established office visit with a -24 modifier and a dx that is different from the original dx for the surgery.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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