Wiki post op

[krssy70]

Can you bill for an office visit following surgery during a global period utilizing the modifier 24 modifier when the physician reviews the pathology report thoroughly and corresponds with the pathologist regarding the findings? This was a prolonged visit and only a very small part of the visit was related to post op follow up.

Thank you,
Kristen Richard, CPC

 

[mitchellde]

Sorry, to review the path report is still considered part of the surgery, it is post op follow up

 

[krssy70]

Do you have any correspondence stating that.. I can't seem to find that in writing.

Thank you

 

[k-jag]

This article may be helpful to you; the author cites her official sources at the end of the article: http://www.facs.org/ahp/pubs/tips/tips0710.pdf

Also, I believe the OIG workplan includes scrutiny of billing for E/M visits during the global surgical period (modifier 24).

The E/M during a global surgical period must clearly document that the reason for the visit is significant and separate from the reason for the surgery. Even though your MD spent a lot of time related to reviewing the pathology report, it's still related to the surgery, so can't see how you could justify it being not related to the surgery. Ask yourself this: If I were sitting on the witness stand in front of CMS, OIG, and lawyers, what argument would I use to defend my use of a modifier 24 in this instance?

Hope this helps