Kae Hunter CPC
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I have been having an ongoing problem getting claims paid due to the fact that we are a multi-specialty practice. When a patient is in the 90-day global with one of our specialists and also sees her PCP who is part of our group; the insurance denies the PCP visit stating it is included in the surgery global. Every conversation I have with the insurance adjustor has them saying I have to append modifier 24 to the claim if I want it to pay. Modifier 24 clearly states E&M by the same physician during the post-op period. Am I missing something here. Is there a modifier that is appropriate for a patient being seen by a different physician; different specialty, in the same practice within the 90-day global?