Help! If a patient has surgery, comes back in and is still having pain, the provider does an MRI and decides that further, more complicated surgery is needed due to a recurrent issue, but on the same level and same dx code, can we charge for an E&M at all? A new exam was performed along with a MRI. It does mention in the note where the decision for the initial surgery was made that this could be a recurrent issue and that further more intense surgery may be required. I know that when the surgery is done that those codes will need a modifier 78. I am asking strictly for the E&M.
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Wiki decision for surgery during a global
- Thread starter Boyd000
- Start date
KMCFADYEN
Expert
you would bill E&M with modifier 24
georgiegirl711
New
coder NC
For the E&M
Here is the guideline :Unrelated E&M service by the same physician during a post-operative period-This modifier can be used to indicate separately identifiable procedures on the same DOS.
If the patient was seen for another issue then I would say yes, Modifier 24 is ok to use.
For the E&M
Here is the guideline :Unrelated E&M service by the same physician during a post-operative period-This modifier can be used to indicate separately identifiable procedures on the same DOS.
If the patient was seen for another issue then I would say yes, Modifier 24 is ok to use.
That is the issue that we are having though, the E&M was for the same issue, during a post op but we did a new exam, an MRI and decided that additional surgery was warranted. At the decision for the first surgery it was mentioned that this could be a recurrent issue. its the same dx and it will be on the same levels of the spine.
KMCFADYEN
Expert
billing it with modifier 24 would be the correct way to bill; it will deny and you will have to send notes to substantiate.