Wiki E/M Modifier for Payment During Global

[graceroni13]

One doctor evaluated and treated the patient with a closed reduction of an elbow. After the surgery it was determined that the injury was more complicated and the patient would need further evaluation and surgery. Patient was referred to a different physician within the same group practice during the post op period who specializes in these more complex elbow injuries. Patient was evaluated in the office and decision was made for further surgery on the elbow(again, during the post op period). He decided to do a radial head replacement, lateral collateral ligament repair, anterior capsulodesis, and ORIF of anteromedial coronoid fracture.

How do you code for the E/M for the second doctor since he made the decision for surgery on the same body part?

 

[dclark7]

Unless the second doctor was a different specialty you cannot bill for the E/M. If he had seen the patient for a different problem you could have billed with a 24 modifier, but since this is related to the original surgery it's not billable.