ED Coding & Reimbursement Alert - 2013 Issue 8
Use modifier 24 when the E/M service meets these criteria
Subscribe or sign in to view the full article.
Article Overview
This article covers when certain E/M-related modifiers may be considered in relation to postoperative care, separately identifiable services, and surgical decision-making. It is aimed at coding and billing professionals who need a broad understanding of modifier use tied to surgical episodes and global periods. The piece focuses on general criteria and relationship to the prior procedure rather than detailed case coding.
Why This Topic Matters
Understanding the scope of these modifiers helps support accurate claim reporting during surgical episodes and reduces the risk of inappropriate E/M bundling or separation.
Article Sections
-
Modifier 24
General criteria related to an E/M service occurring in a postoperative period and being unrelated to a prior procedure.
-
Modifier 25
General criteria for a separately identifiable E/M service provided in addition to another service or usual preoperative/postoperative care.
-
Modifier 57
General criteria connecting an E/M service with the decision to perform a surgery that has a global period.
What You Will Learn
- The broad situations in which these E/M-related modifiers are discussed
- How the article distinguishes postoperative, separately identifiable, and decision-for-surgery scenarios
- The types of provider and service relationships addressed by the guidance
- How the article frames the role of global periods in modifier discussion
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Physician practice administrators
- Compliance staff
Modifiers Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com