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E/m coding within global

  1. #1
    Default E/m coding within global
    Medical Coding Books
    My physician performed cataract surgery to a patient's right eye. During the 90 day global period, he evaluated the cataract in the left eye and decided to schedule cataract surgery. Because the cataract is unrelated to the initial surgery, can he charge an E/M during global, with modifiers 24/25 w/supporting documentation/medical necessity?

  2. #2
    Default
    If he saw the patient and decided to perform surgery on that exam then yes you can bill an e/m with 24 and 57 if the exam occured the day of or day before the surgery. If on the initial visit the doctor evaluted the right eye and left eye and was decided to perform surgery on both and patient comes in for follow up on right eye and doctor says it's ok to proceed with left eye surgery then you cannot bill the e/m. Hope this helps !

  3. #3
    Default
    I have a similar situation. Patient was here during the post-op and the surgery for
    Other eye was planned and testing was doneThe e/m code was billed with modifier 24 and 57 but Medicare is denying as inclusive in another procedure.

  4. #4
    Default Mod-24 or 57
    Quote Originally Posted by coderpreety View Post
    I have a similar situation. Patient was here during the post-op and the surgery for
    Other eye was planned and testing was doneThe e/m code was billed with modifier 24 and 57 but Medicare is denying as inclusive in another procedure.
    Either you need to append Mod-24 or 57 with E/M code depends upon global day's of current surgery code you selected. No need to append both Modifiers with E/M CPT code.

    It helps you!!!!

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