tci General Surgery Coding Alert - 2013 Issue 8

Use modifier 24 when the E/M service meets these criteria

The E/M service occurs during the postoperative period of another procedure The current E/M service is unrelated to the previous procedure The same physician (or tax ID) who performed the previous procedure provides the E/M. Use modifier 25 if the claim meets all of the following criteria: The patient’s condition requires a significant, separately identifiable E/M service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the [surgery] The separate E/M may be for a different condition (diagnosis) than the procedure, but not necessarily The same surgeon (or another surgeon...

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