you cannot use 79 on an E&M and 24 is for a service provided within the global, which an initial visit is not. The issue is if you knew the patient was comming to you as a referral for the purpose of a colonoscopy then you cannot charge for an initial encounter since the patient has already been seen by a different physician and has determined the need for the procedure. If the decision for a colonsocopy has not been made prior to the patient being evaluated by your physician then there is no need for any modifier, however you may need to provide documentation to prove that the patient was not sent for the purpose of the test.
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