Modifier Coding Alert
Pick Modifier 24 with Unrelated E/M
Question: One of my physicians’ patients came into our office for a follow-up visit related to the removal of a lump (11604) near her knee that she had two weeks ago. The surgeon confirms the outgrowth to be a sarcoma of the bone (170-176, Malignant neoplasm of bone and articular cartilage). When the patient comes back in to the office for review, the surgeon does an extensive office visit with the patient to discuss the change in treatment. Do I need a modifier on the E/M service?
Minnesota Subscriber
Answer: If your physician expected the sarcoma outcome and the course of treatment doesn’t change, the visit would be a post-op 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason[s] related to the original procedure).
If, however, the sarcoma was a potential outcome, not an expected outcome by your physician, and the treatment course is going in a different, more involved direction, you could code the visit with the appropriate level of service illustrated in the note with modifier 24 (Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period) attached to a new diagnosis.
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