General Surgery Coding Alert - 2019 Issue 2
Modifier Use: Remember These 3 Facts, Bust This 1 Myth, for Accurate Modifier 24 Application
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Article Overview
This article discusses how to recognize when an evaluation and management service occurs during a postoperative global period and how that affects modifier use. It is written for coding and billing professionals who need to understand global surgical packages, postoperative visit documentation, and auditor scrutiny in order to support accurate claim reporting.
Why This Topic Matters
Accurate handling of postoperative services can affect claim acceptance, compliance, and audit risk. The article helps readers distinguish between services included in a surgical package and services that may be separately reportable during the global period.
Article Sections
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Global Days Are Essential
This section introduces global surgical packages and explains the broad categories of services included in postoperative periods. It also reviews which types of services may fall outside the package and therefore require closer coding review.
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24 Only Applies to E/M Codes
This section focuses on the scope of modifier 24 and its relationship to evaluation and management reporting during a global period. It emphasizes the need to distinguish E/M services from procedures when considering modifier use.
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Auditors Examine Whether Visit Was Related to Surgery
This section describes documentation and audit considerations that affect how postoperative visits are evaluated. It highlights the importance of record support when distinguishing related from unrelated services.
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Myth: Returning Patients to the OR Warrants Modifier 24
This section addresses a common misconception about postoperative complications and return-to-OR scenarios. It contrasts that situation with other modifier considerations discussed in the article.
What You Will Learn
- How global surgical periods shape postoperative service reporting
- What types of services are generally discussed in relation to the global surgical package
- How modifier 24 is positioned within postoperative evaluation and management reporting
- Why documentation and audit review matter when reporting services during the global period
- How a return-to-OR scenario is treated differently from unrelated postoperative evaluation and management services
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Revenue cycle teams
- Eye care coding professionals
Codes Discussed
Modifiers Discussed
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