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Thread: Help with E/M codes

  1. #1

    Default Help with E/M codes

    AAPC: Back to School
    Hi everyone. I am in need of some help regarding E/M coding. Ex: PT comes in on 7/15/2011 with CPT code 99202 DX 238.2. He then comes in 10 days later with CPT 99213 and same DX of 238.2. Would there be a modifier of -24? Our doctors are questioning the use of -24 modifier for PTs that only have E/M services done. They are wanting documentation showing how a global period pertains if there was no surgery ever performed.

    Any feedback is appreciated.
    Nikki Newton

  2. #2
    Join Date
    Apr 2007
    Fullerton/Buena Park, CA


    No modifier is needed for a return visit unless the patient had surgery and is still in the post-op period.

    ex: pt had cataract surgery on the right eye (90-day global), pt comes in a few days later with pain the the left eye. Since the pain in left eye is not related to the cataract surgery in the right eye, you would append modifier -24 to the e/m code as well as modifier -LT to let insurance know it's not related to surgery.

    In regards to global periods, you can go to your local Medicare website or CMS.org. Medicare/CMS will have a list of procedures and what the global period is for that procedure or if the procedure has a global period.
    Jennifer DeWitte, CPC, CPC-P, CPB
    Newport Center Surgical
    Coding & Billing Department

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