According to CPT, what can be reported with Modifier -24?

Study for the AAPC CEMC exam with our comprehensive quiz material, flashcards, and multiple choice questions. Gain insights with detailed explanations and hints to help you prepare effectively for the test.

Modifier -24 is specifically used in the context of Evaluation and Management (E/M) services to indicate that a service is unrelated to the procedure performed during a postoperative global period. This modifier can be appended to an E/M service when the patient requires additional assessment or management for a condition that is not related to the recent surgical procedure.

When a physician provides services to address an unrelated problem during the global period following surgery, it is crucial to use modifier -24 to indicate that the visit was separate from the surgical procedure and should be billed accordingly. This categorization allows for appropriate reimbursement for the E/M service provided, even though the patient is still within the global period of the surgical procedure.

Understanding modifier -24 is vital for correct coding practices, as it not only aids in proper reimbursement but also ensures the distinction between different types of services is clear in a patient’s medical records. This distinction is essential for both clinical management and billing purposes.

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