carol52
Expert
If the pt is in a global and a minor procedure is done durring that 90 day global , what modifiers should be used ?
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Wiki Can you bill a 24 and a 25 on same date
- Thread starter carol52
- Start date
btadlock1
Guest
I don't understand
...Are you saying that a procedure was done, or an E/M?
If the patient had a major procedure w/a 90 day global period, and you have...
...an E/M ONLY during the post-op period, you will need a 24 modifier on the E/M.
...a minor procedure only (All of these examples are assuming that the provider is the one who performed the first surgery, by the way): the minor procedure will need a 79 modifier. 24 & 25 only go on E/M codes.
...a minor procedure AND a significant/separately identifiable E/M on the same day: Yes, the E/M will need both a 24 and a 25, and the procedure needs a 79, as long as the procedure code is one with a global period of its own (I just learned that some of the codes starting at 12001 no longer have global periods, so check your NCCI edit tables here:http://www.cms.gov/NationalCorrectCodInitEd/NCCIEP/list.asp). If the minor procedure doesn't have a global period and doesn't bundle to your E/M code, then just put a 24 on the E/M and a 79 on the procedure.
I hope that helps!
...Are you saying that a procedure was done, or an E/M?If the patient had a major procedure w/a 90 day global period, and you have...
...an E/M ONLY during the post-op period, you will need a 24 modifier on the E/M.
...a minor procedure only (All of these examples are assuming that the provider is the one who performed the first surgery, by the way): the minor procedure will need a 79 modifier. 24 & 25 only go on E/M codes.
...a minor procedure AND a significant/separately identifiable E/M on the same day: Yes, the E/M will need both a 24 and a 25, and the procedure needs a 79, as long as the procedure code is one with a global period of its own (I just learned that some of the codes starting at 12001 no longer have global periods, so check your NCCI edit tables here:http://www.cms.gov/NationalCorrectCodInitEd/NCCIEP/list.asp). If the minor procedure doesn't have a global period and doesn't bundle to your E/M code, then just put a 24 on the E/M and a 79 on the procedure.
I hope that helps!
Last edited:
carol52
Expert
Thanks
I billed out the 24 for a major global period, a 25 for E&M for the same day as a procedure and a 79. This was all on the same dos. Medicaid denied for 24.
I billed out the 24 for a major global period, a 25 for E&M for the same day as a procedure and a 79. This was all on the same dos. Medicaid denied for 24.
btadlock1
Guest
Interesting...Are you sure about the global period on the first procedure? This may help:
http://www.wpsmedicare.com/part_b/education/modifier_24.pdf
http://www.wpsmedicare.com/part_b/education/modifier_24.pdf