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modifier

  1. #1
    Default modifier
    Medical Coding Books
    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???

  2. #2
    Default
    If you are billing an E/M code, you would use modifier 24.

    Hope this helps!

    Teresa Collins, CPC

  3. #3
    Default modifier
    i don't think this applies b/c we are not an ambulatory sugical center we are a physician's office, thanks though

  4. #4
    Location
    North Carolina
    Posts
    3,126
    Default
    Modifier 24 can be used for POS 11(place of service), physician office.

    http://www.donself.com/modifier.html

    http://www.medicarenhic.com/provider...rgeryguide.pdf

    on the 2nd link, review page 9
    Rebecca CPC, CPMA, CEMC




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  5. Default
    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!!

  6. #6
    Location
    Bettendorf, Iowa
    Posts
    133
    Default
    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.

  7. #7
    Default modifier
    yes this makes more sense to me now, thanks guys!

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