Podiatry billing guidelines: You need to train eyes on podiatrist's documentation and not the appointment book.
In order to seal your payments for services your podiatrist carries out after a major procedure while you are still billing in the global period of the procedure, you need to be well-versed with the ins and outs of modifier 24.
Here are some myths relating to this modifier that you can stay away from:
Modifier 24 is applicable to any service done in the post-op period – this is a no.
You should add modifier 24 to an appropriate E/M code when an evaluation & management service takes place during a postoperative global period for reasons not related to the original procedure. This modifier tells the payer that the surgeon is treating the patient for a new problem. As such, the plan shouldn't include the evaluation & management service in the previous procedure's global surgical package.
This modifier is only for use on E/M codes and only for use during the post-operative period (10 or 90 days).
As a rule, you cannot bill separately for evaluation & management related services pertaining to the original surgery during the global period. This surgical package includes routine postoperative care during the global period.
Scheduled office visit means no modifier 24
Don't assume you are unable to bill separate services using modifier 24 just because of the fact that a patient was scheduled to visit related to the surgery.
Here's an example to substantiate this: A patient has a lumpectomy. When the patient comes back in to the office for sutures pathology has found out that the lump turned out to be cancer. As such, the doctor does an extensive E/M service/office visit with the patient to discuss.
Here, you should be able to use modifier 24 to describe an evaluation & management service not related to the surgery. CPT would always allow this, however even Medicare says that care directed at the underlying disease process is billable separately in the global period.
In order to seal your payments for services your podiatrist carries out after a major procedure while you are still billing in the global period of the procedure, you need to be well-versed with the ins and outs of modifier 24.
Here are some myths relating to this modifier that you can stay away from:
Modifier 24 is applicable to any service done in the post-op period – this is a no.
You should add modifier 24 to an appropriate E/M code when an evaluation & management service takes place during a postoperative global period for reasons not related to the original procedure. This modifier tells the payer that the surgeon is treating the patient for a new problem. As such, the plan shouldn't include the evaluation & management service in the previous procedure's global surgical package.
This modifier is only for use on E/M codes and only for use during the post-operative period (10 or 90 days).
As a rule, you cannot bill separately for evaluation & management related services pertaining to the original surgery during the global period. This surgical package includes routine postoperative care during the global period.
Scheduled office visit means no modifier 24
Don't assume you are unable to bill separate services using modifier 24 just because of the fact that a patient was scheduled to visit related to the surgery.
Here's an example to substantiate this: A patient has a lumpectomy. When the patient comes back in to the office for sutures pathology has found out that the lump turned out to be cancer. As such, the doctor does an extensive E/M service/office visit with the patient to discuss.
Here, you should be able to use modifier 24 to describe an evaluation & management service not related to the surgery. CPT would always allow this, however even Medicare says that care directed at the underlying disease process is billable separately in the global period.
