Podiatry Coding & Billing Alert

Question: A podiatrist sees a 57-year-old female who's returning to the office under a 10-day global for a postoperative check following a chemical matrixectomy (11730, Avulsion of nail plate, partial or complete, simple; single). The patient returns for check-up, and towards the end complains of heel pain in the left foot. The physician proceeds to check it out. How should you report this?

Answer: Since the patient's checkup is under the global period, you'd code 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) for a zero-charge, and for the foot pain checkup, you'd code the appropriate level-one, -two or -three E/M with a modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).

Hint: Only an E/M service warrants the use of modifier 25. You should check if the encounter qualifies for modifier 59 (Distinct procedural service) if you're using a non-E/M code.