ED Coding & Reimbursement Alert - 2018 Issue 5
You Be the Coder: Append These 2 Modifiers When Circumstances Allow
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Article Overview
This coding Q&A article addresses billing scenarios involving evaluation and management services in a postoperative period, including how multiple modifiers may be applied when care is unrelated to the original surgery and another procedure occurs on the same day. It is aimed at coders, billers, and revenue cycle staff who need to understand general claim-setup concepts and postoperative modifier usage without relying on the full premium discussion.
Why This Topic Matters
Postoperative claims can be edited differently depending on the relationship between the visit, the original surgery, and any additional procedure performed on the same day. Understanding the article helps coding professionals recognize when modifier combinations and claim sequencing are relevant.
Article Sections
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Question
A brief coding question about reporting evaluation and management modifiers on the same claim.
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Answer
General discussion of postoperative-period claim scenarios involving evaluation and management services and another procedure on the same date.
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Example
A scenario illustrating a postoperative visit with an unrelated issue and an additional procedure performed during that encounter.
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Tip
A short note about modifier sequencing and claim edit processing in the postoperative period.
What You Will Learn
- How the article frames reporting of evaluation and management services in a postoperative setting.
- How same-day procedure circumstances are discussed in relation to claim submission.
- What types of postoperative claim-processing considerations are mentioned.
- How the article presents modifier sequencing as a general billing concept.
Who Should Read This
- Medical coders
- Professional billers
- Revenue cycle staff
- Practice managers
- Coding educators
Modifiers Discussed
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