Thursday, February 18, 2010

Medicare Part B Modifier - 24

Medicare Part B Modifier - 24

Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: The physician may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. This circumstance may be reported by adding the modifier 24 to the appropriate level of E/M service.

In order for the evaluation and management service to be payable in the postoperative period with the 24 modifier, the diagnosis code supporting the E/M service must be different from the diagnosis code reported for the previously performed surgery.

Donot Use Modifier - 24

Modifier 24 should not be used for the medical management of a patient by the surgeon following surgery.

Medicare recognizes modifier 24 only for the care following a discharge under these circumstances:

The care is for immunotherapy management furnished by the transplant surgeon;
The care is for critical care (99291, 99292) for a burn or trauma patient under diagnosis codes 800.0-929.9, 940.0-959.9; or The documentation demonstrates that the visit occurred during a subsequent hospitalization and the diagnosis supports the fact that it is unrelated to the original surgery.

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