Wiki Modifier -24

[klauf]

I am looking for some clarification on the use of modifier -24. I work for a cardiology group who also has an electrophysilogist apart of the practice. We do have patients who have pacer/defib implants that are then seen in the office within the 90 day global period by one of our regular cardiologist. Is it appropriate to use modifier -24 for these E/M services even if they are seeing the patient for the follow up of the implant since they are not of the same specialty per say. They do discuss the patient's underlying conditions after discussing the reason for the implant. I would greatly appreciate any help since this has been a long topic of debate.

 

[pezztx]

Cardiology is the same no matter what the expertise. If they are in the same office/group -24 can only be used if they have other problems, other than the pacemaker, that are addressed.

 

[laauserc1]

different dx; different issues; use 24. Just keep in mind that even when you append the modifier 24, there is still a large chance it will be kicked electronically ( new editing systems). you may find that dropping to paper with office notes is the fastest way to get the reimbursement.

 

[twizzle]

Cardiology is the same no matter what the expertise. If they are in the same office/group -24 can only be used if they have other problems, other than the pacemaker, that are addressed.

Electrophysiology is actually a different subspecialty to cardiology and EP providers have a different taxonomy classification so cardiology is not the same no matter what the expertise.