Question: If the otolaryngologist sees a patient postoperatively for one hour to discuss the plan of care, can he charge an E/M code with modifier 24 attached?
Kentucky Subscriber
Answer: If the otolaryngologist is discussing a treatment plan, such as additional surgical intervention (for example, if the physician just received the biopsy results and needs to discuss options) or chemotherapy/radiation, you can charge an E/M code (99212-99215 for outpatients) based on the amount of time the physician spends with the patient. You should append modifier 24 (Unrelated evaluation and management service by the same physician during a postoperative period) to the E/M code.
To improve your chances of reimbursement, you should link a new diagnosis code to the E/M claim. For example, if the patient's original diagnosis was a mass or neoplasm of unspecified nature, you-ll want to link the new, specific diagnosis to the new claim, such as a malignant neoplasm ICD-9 code.
Make sure your documentation indicates the total time that the physician spent with the patient, how much of the visit your surgeon spent counseling the patient, and what they discussed.
